Active NPI
Craig D McKernin, PA
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1477592780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001302-1
- Practice address
- 40 Flatbush Avenue Ext
8TH Floor
Brooklyn, NY 11201-1906 - Phone
- (718) 439-4358
- NPI assigned
- Jun 5, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001302-1 | NY | Primary |
Addresses
Primary practice location
40 Flatbush Avenue Ext
8TH Floor
Brooklyn, NY 11201-1906
Mailing address
38 6TH Ave
Huntington Station, NY 11746-2207
Phone (718) 439-4358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001302 | NY | MD | Mental Health Counselor |
| 001302-1 | NY | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1477592780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 6TH AVE",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117462207",
"telephone_number": "718-439-4358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 FLATBUSH AVENUE EXT",
"address_2": "8TH FLOOR",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011906",
"telephone_number": "718-439-4358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKERNIN",
"first_name": "CRAIG",
"middle_name": "D",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "001302-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.