Individual provider Active NPI

Kevin Hastings III, FNP

  • Family Nurse Practitioner
  • Vestal, NY
National Provider Identifier
1609257468
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339755 Issued in NY
Practice address
200 Front St
Suite a
Vestal, NY 13850-1559
Phone
(607) 748-9001
NPI assigned
Jun 17, 2015
Last updated
Jun 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 339755 NY Primary

Addresses

Primary practice location

200 Front St
Suite a
Vestal, NY 13850-1559

Mailing address

200 Front St
Suite a
Vestal, NY 13850-1559
Phone (607) 748-9001

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150820010693 NY Practitioner - Nurse Practitioner 1951616861 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trumansburg Medicine PLLC CurrentSince Jul 20, 2015 Accepting new patients
Osteopathic Pain Management Services LLC Past Accepting new patients

Locations

4435 Seneca Rd
Trumansburg, NY 14886
Phone (607) 387-5707

4435 Seneca Rd
#H
Trumansburg, NY 14886
Phone (607) 387-5707

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1609257468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FRONT ST",
            "address_2": "SUITE A",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501559",
            "telephone_number": "607-748-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FRONT ST",
            "address_2": "SUITE A",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501559",
            "telephone_number": "607-748-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "KEVIN",
        "name_suffix": "III",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.