Individual provider Active NPI

Kristin Rebecca Grovenger, FNP-C

  • Family Nurse Practitioner
  • Slingerlands, NY
National Provider Identifier
1669065900
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
347332 Issued in NY
Practice address
1882 New Scotland Rd Ste 200
Slingerlands, NY 12159-3627
Phone
(518) 439-2460
Fax
(518) 439-3025
NPI assigned
Feb 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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 347332 NY Primary

Addresses

Primary practice location

1882 New Scotland Rd Ste 200
Slingerlands, NY 12159-3627

Mailing address

711 Troy Schenectady Rd Ste 203
Latham, NY 12110-2461
Phone (518) 782-3700

Other names 1

  • Kristin Rebecca Ronk Former name

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
I20210311002396 NY Practitioner - Nurse Practitioner 2466868781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

1882 New Scotland Rd
Suite 200
Slingerlands, NY 12159-3627
Phone (518) 439-2460

Hospital & facility affiliations

  • Eddy Visiting Nurse & Rehab Association Home health agency, Troy, NY, CCN 337203
  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC CurrentSince Mar 8, 2021 Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

1882 New Scotland Rd
Ste 200
Slingerlands, NY 12159
Phone (518) 439-2460

1882 New Scotland Rd
Slingerlands, NY 12159
Phone (518) 435-1400

Interoperability endpoints

  • Direct secure messaging: kristingrovenger@ccp.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1669065900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1882 NEW SCOTLAND RD STE 200",
            "city": "SLINGERLANDS",
            "state": "NY",
            "postal_code": "121593627",
            "telephone_number": "518-439-2460",
            "fax_number": "518-439-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVENGER",
        "first_name": "KRISTIN",
        "middle_name": "REBECCA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "347332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "RONK",
            "middle_name": "REBECCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Slingerlands, NY

Sources for this page

Verify at the official NPI Registry.