Krystle Callan

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F311860-01 Issued in NY

Practice address

111 Beach Dr
West Islip, NY 11795-4929

Phone

(631) 417-8643

NPI assigned

Jul 10, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: kcallan102790@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 and National Provider Directory roles.

• CHS Physician Partners, PC

  • Interventional Cardiology Physician
  • Fresh Meadows, NY
  • NPI 1407089345

  Single Specialty

  Medicare reassignment Care Compare group NPD
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725

  Single Specialty

  NPD
• CHS Physician Partners, PC

  • Family Medicine Physician
  • Bellmore, NY
  • NPI 1720334527

  Single Specialty

  NPD

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

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1497592299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 MASSACHUSETTS AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117584218",
            "telephone_number": "516-737-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BEACH DR",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954929",
            "telephone_number": "631-417-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAN",
        "first_name": "KRYSTLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311860-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Calcasola
• Mike E Calderon, DDS
• Sunday Jean Caldwell, NP
• Kathleen Calhoun
• Elizabeth Callahan, PA
• Elizabeth Rose Cambra, SOCIAL WORKER
• Tracy Lynn Campbell
• Laura Candelaria, FNP
• Stephanie Cantante
• Gregg Cantor, DO

• Adult Health Nurse Practitioner in West Islip, NY
• Providers in West Islip, 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 Jul 10, 2024; 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.