Active NPI
Kyle Cobb
- Adult Health Nurse Practitioner
- Bay Shore, NY
National Provider Identifier
1538059571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 312351
- Practice address
- 1745 Union Blvd
Bay Shore, NY 11706-7952 - Phone
- (631) 323-4255
- NPI assigned
- Jul 9, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 312351 | NY | Primary |
Addresses
Primary practice location
1745 Union Blvd
Bay Shore, NY 11706-7952
Mailing address
90 Woodsome Rd
Babylon, NY 11702-3318
Phone (631) 495-0085
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 312351 | NY | MD | Pediatrics Physician |
Interoperability endpoints
- kyle.cobb.1@20167.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752019200000",
"number": "1538059571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 WOODSOME RD",
"city": "BABYLON",
"state": "NY",
"postal_code": "117023318",
"telephone_number": "631-495-0085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1745 UNION BLVD",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117067952",
"telephone_number": "631-323-4255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBB",
"first_name": "KYLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-07-09",
"last_updated": "2025-07-09",
"certification_date": "2025-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "312351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.