Individual provider Active NPI

Kristen Anne Kleinman, NP

  • Women's Health Nurse Practitioner
  • Port Washington, NY
National Provider Identifier
1720381882
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
F421010-1 Issued in NY
Practice address
88 Summit Rd
Port Washington, NY 11050-3341
Phone
(516) 633-0343
NPI assigned
Dec 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X F421010-1 NY Primary

Addresses

Primary practice location

88 Summit Rd
Port Washington, NY 11050-3341

Mailing address

88 Summit Rd
Port Washington, NY 11050-3341
Phone (516) 633-0343

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
I20180404002661 NY Practitioner - Nurse Practitioner 1052674009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F421010-1NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Feb 5, 2018 Accepting new patients
North Shore - Lij Medical PC CurrentSince Feb 5, 2018 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1720381882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 SUMMIT RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503341",
            "telephone_number": "516-633-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 SUMMIT RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503341",
            "telephone_number": "516-633-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINMAN",
        "first_name": "KRISTEN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "F421010-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

Verify at the official NPI Registry.