Individual provider Active NPI

Kathleen Michele Kizzee, AGPCNP-BC

  • Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1669063566
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
308963 Issued in NY
Practice address
5075 W Seneca Tpke
Syracuse, NY 13215-3216
Phone
(315) 449-6000
NPI assigned
Feb 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 308963 NY Primary

Addresses

Primary practice location

5075 W Seneca Tpke
Syracuse, NY 13215-3216

Mailing address

122 Marian Dr
Mattydale, NY 13211-1826
Phone (315) 289-5092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1643 NW 136TH Ave
Sunrise, FL 33323-2857

1643 NW 136TH Ave
Sunrise, FL 33323-3091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209022489ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1669063566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 MARIAN DR",
            "city": "MATTYDALE",
            "state": "NY",
            "postal_code": "132111826",
            "telephone_number": "315-289-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 W SENECA TPKE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132153216",
            "telephone_number": "315-449-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZZEE",
        "first_name": "KATHLEEN",
        "middle_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "308963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.