Active NPI
Keisha Simone Bennett, FNP
- Family Nurse Practitioner
- Brooklyn, NY
National Provider Identifier
1598003808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F337490-1
- Practice address
- 451 Clarkson Ave
Brooklyn, NY 11203-2054 - Phone
- (718) 245-3495
- NPI assigned
- Jan 21, 2013
- Sex
- Female
- Sole proprietor
- No
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 | F337490-1 | NY | Primary |
Addresses
Primary practice location
451 Clarkson Ave
Brooklyn, NY 11203-2054
Mailing address
610 E 38TH St
Brooklyn, NY 11203-5610
Phone (718) 941-7771
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130624000729 | NY | Order and Referring Only - Family Practice | 3476792474 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 337490 | NY | MD | Hospitalist Physician |
| F337490-1 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358726400000",
"number": "1598003808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 E 38TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112035610",
"telephone_number": "718-941-7771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 CLARKSON AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032054",
"telephone_number": "718-245-3495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "KEISHA",
"middle_name": "SIMONE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-21",
"last_updated": "2013-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F337490-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.