Kevin Carver Mastroianni, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

690182 Issued in NY

Practice address

3 Morning Glory Dr
Ballston Spa, NY 12020-3345

Phone

(518) 621-8579

NPI assigned

Nov 5, 2021

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1518622307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MORNING GLORY DR",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120203345",
            "telephone_number": "518-621-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MORNING GLORY DR",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120203345",
            "telephone_number": "518-621-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROIANNI",
        "first_name": "KEVIN",
        "middle_name": "CARVER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-05",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "690182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Ballston Spa, NY
• Providers in Ballston Spa, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.