Individual provider Active NPI

Lauren I Krzos

  • Physician Assistant
  • Massapequa, NY
National Provider Identifier
1689203606
Registry record updated Jan 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
026022 Issued in NY
Practice address
550 Broadway
Massapequa, NY 11758-5013
Phone
(516) 809-9666
Fax
(516) 809-9665
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 026022 NY Primary

Addresses

Primary practice location

550 Broadway
Massapequa, NY 11758-5013

Mailing address

550 Broadway
Massapequa, NY 11758-5013
Phone (516) 809-9666

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
I20251008000947 NY Practitioner - Physician Assistant 6608281803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 1554
Stony Brook, NY 11790

PO Box
Suite 1554
Stony Brook, NY 11790-0988

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
026022NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Surgical Associates, University Faculty Practice Corporati CurrentSince Oct 7, 2025 Accepting new patients
New York Integrative Rheumatology&Arthritis Care, PC PastSince Feb 8, 2023 Accepting new patients

Locations

Lauterbur Dr Lvl 5
Rm 5M0203
Stony Brook, NY 11794

100 Nicolls Rd
#5
Stony Brook, NY 11794
Phone (631) 444-7653

100 Nicolls Rd
Stony Brook, NY 11790
Phone (631) 444-1069

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794
Phone (631) 638-0800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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 6

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674950400000",
    "number": "1689203606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585013",
            "telephone_number": "516-809-9666",
            "fax_number": "516-809-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585013",
            "telephone_number": "516-809-9666",
            "fax_number": "516-809-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRZOS",
        "first_name": "LAUREN",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-01-29",
        "certification_date": "2023-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.