Active NPI
Kelsie Moinzadeh Lange
- Family Nurse Practitioner
- Clifton Park, NY
National Provider Identifier
1508773292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F359241-01
- Practice address
- 939 Route 146 Ste 700
Clifton Park, NY 12065-3662 - Phone
- (518) 383-0891
- NPI assigned
- Aug 26, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F359241-01 | NY | Primary |
Addresses
Primary practice location
939 Route 146 Ste 700
Clifton Park, NY 12065-3662
Mailing address
80 Cypress St
Ballston Lake, NY 12019-1751
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1508773292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 CYPRESS ST",
"city": "BALLSTON LAKE",
"state": "NY",
"postal_code": "120191751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 ROUTE 146 STE 700",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120653662",
"telephone_number": "518-383-0891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "KELSIE",
"middle_name": "MOINZADEH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-08-26",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F359241-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clifton Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.