Individual provider Active NPI

Nicholas Kuster

  • Physician Assistant
  • Holbrook, NY
National Provider Identifier
1487387684
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1200 Bastow St
Holbrook, NY 11741-3811
Phone
(631) 585-0807
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1200 Bastow St
Holbrook, NY 11741-3811

Mailing address

1200 Bastow St
Holbrook, NY 11741-3811
Phone (631) 585-0807

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
I20221219000620 NY Practitioner - Physician Assistant 4183093966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Suffolk HospitalGroup PAC ID 4981508082, 94 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6101

Hospital & facility affiliations

  • Peconic Bay Medical Center Hospital, Riverhead, NY, CCN 330107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Suffolk Hosptial CurrentSince Sep 12, 2022 Accepting new patients

Locations

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

Interoperability endpoints

  • Direct secure messaging: nkuster70021@northwell.direct-ci.com

Organizations & group practices 2

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 1

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1487387684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BASTOW ST",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117413811",
            "telephone_number": "631-585-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BASTOW ST",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117413811",
            "telephone_number": "631-585-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSTER",
        "first_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

Verify at the official NPI Registry.