Kristin Rose McDonough

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

026791 Issued in NY

Practice address

55 E Old Country Rd
Hicksville, NY 11801-4293

Phone

(169) 876-4285

NPI assigned

Jul 15, 2021

Last updated

Nov 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cross Bay Orthopedic Surgery PC

  • Orthopaedic Surgery Physician
  • Forest Hills, NY
  • NPI 1346913183
  NPD (past)

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1639741846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATLANTIC AVE APT 78",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352772",
            "telephone_number": "631-560-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E OLD COUNTRY RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014293",
            "telephone_number": "169-876-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "KRISTIN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "026791",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "026791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leena Mathew, BSC. PHARMACY RPH
• Smith Maxume, PMHNP
• Shirley Renae McCall, RN
• Jaclyn McCarthy
• Jeanetta S McCloud
• Joshua Jeffrey McDowell
• Ambar McGinley, LCSW
• Ryan Hope McGovern
• Patrick E McGunnigle, DDS
• Kristie McKasty, LMHC

• Medical Physician Assistant in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.