Kelly Jean Wisniewski, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

312048 Issued in NY

Practice address

100 Port Washinton Blvd
Roslyn, NY 11576

Phone

(516) 390-9640

NPI assigned

Mar 27, 2025

Last updated

Mar 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Jean O'Brien Former name

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kobrien101306@direct-chsli.net

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

• CHS Physician Partners, PC

  dba Cardiac Interventional Group

  • Interventional Cardiology Physician
  • Fresh Meadows, NY
  • NPI 1407089345
  Medicare reassignment Care Compare group NPD
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD

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

• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1043279565
  Care Compare affiliation

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

{
    "created_epoch": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1467254425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRANKEL RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117587260",
            "telephone_number": "516-780-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-390-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "312048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "O'BRIEN",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Stacey M Wink, M.S.
• Brandon Wolfson, PA-C
• Mitchell Wolfson, MD
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• Joseph William Woo, M.D.

• Adult Health Nurse Practitioner in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.