Active NPI
Petr Kanevskiy
- Certified Registered Nurse Anesthetist
- Huntington, NY
National Provider Identifier
1417867698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 788151
- Practice address
- 270 Park Ave
Huntington, NY 11743-2787 - Phone
- (631) 351-2000
- NPI assigned
- Sep 9, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 788151 | NY | |
| Certified Registered Nurse Anesthetist | 367500000X | 788151 | NY | Primary |
Addresses
Primary practice location
270 Park Ave
Huntington, NY 11743-2787
Mailing address
100 Village SQ Apt 203
Glen Cove, NY 11542-2598
Phone (347) 342-6480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1417867698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 VILLAGE SQ APT 203",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115422598",
"telephone_number": "347-342-6480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 PARK AVE",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117432787",
"telephone_number": "631-351-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANEVSKIY",
"first_name": "PETR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-09",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "NY",
"license": "788151",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NY",
"license": "788151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Huntington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.