Individual provider Active NPI

Merissa Ann Kochanski, NP

  • Acute Care Nurse Practitioner
  • Sunnyside, NY
National Provider Identifier
1417415068
Registry record updated Mar 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
431395 Issued in NY
Practice address
4739 40TH St Apt 6G
Sunnyside, NY 11104-4034
Phone
(917) 417-9045
NPI assigned
Mar 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 431395 NY Primary

Addresses

Primary practice location

4739 40TH St Apt 6G
Sunnyside, NY 11104-4034

Mailing address

4739 40TH St Apt 6G
Sunnyside, NY 11104-4034
Phone (917) 417-9045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200715002013 NY Practitioner - Nurse Practitioner 2769806355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Urgent Care GroupGroup PAC ID 6507878675, 46 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-7203

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
61.43
Improvement activities
40
Cost
79.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
431395NYMDAcute Care Nurse Practitioner

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mkochanski22959@mskcc.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551571200000",
    "number": "1417415068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4739 40TH ST APT 6G",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111044034",
            "telephone_number": "917-417-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4739 40TH ST APT 6G",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111044034",
            "telephone_number": "917-417-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHANSKI",
        "first_name": "MERISSA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-03",
        "last_updated": "2019-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, NY

Sources for this page

Verify at the official NPI Registry.