Individual provider Active NPI

Kristen Monteiro, RN

  • Family Nurse Practitioner
  • Centereach, NY
National Provider Identifier
1477096956
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F357400 Issued in NY
Practice address
1344 Middle Country Rd
Centereach, NY 11720-3583
Phone
(631) 268-3010
NPI assigned
Dec 1, 2016
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F357400 NY Primary
School Registered Nurse 163WS0200X 654121 NY

Addresses

Primary practice location

1344 Middle Country Rd
Centereach, NY 11720-3583

Mailing address

1344 Middle Country Rd Ste 1
Centereach, NY 11720-3584
Phone (631) 561-7484

Other names 1

  • Kristen Bucalo Former name

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
I20250919003225 NY Practitioner - Nurse Practitioner 1557865664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brookhaven Heart PLLCGroup PAC ID 6305846114, 24 clinicians

Practice addresses (Care Compare)

325 E Main St
Suite 120
Patchogue, NY 11772-3114
Phone (631) 654-3278

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
654121NYMDSchool Registered Nurse
F357400NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brookhaven Heart PLLC CurrentSince Sep 1, 2025 Accepting new patients
William Floyd School District Past Accepting new patients
Kumar S Mandal MD PC PastSince Aug 26, 2002 Accepting new patients
MD 365 Medical Care PLLC PastSince Apr 1, 2019 Accepting new patients
Suffolk Home Care LLC PastSince Oct 13, 2019 Accepting new patients

Locations

325 E Main St
Ste 120
Patchogue, NY 11772
Phone (631) 654-3278

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEFCAA

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1477096956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 MIDDLE COUNTRY RD STE 1",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203584",
            "telephone_number": "631-561-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 MIDDLE COUNTRY RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203583",
            "telephone_number": "631-268-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEIRO",
        "first_name": "KRISTEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F357400",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "654121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "BUCALO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Centereach, NY

Sources for this page

Verify at the official NPI Registry.