Active NPI
Kyler None Prinz
- Certified Registered Nurse Anesthetist
- Port Jefferson, NY
National Provider Identifier
1730024563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 787129
- Practice address
- 200 Belle Terre Rd
Port Jefferson, NY 11777-1928 - Phone
- (631) 862-3538
- NPI assigned
- Apr 20, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 787129 | NY | Primary |
| Registered Nurse | 163W00000X | 787129-01 | NY |
Addresses
Primary practice location
200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Mailing address
50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7 Whiskey Rd
Coram, NY 11727-2712
PO Box
Suite 136
Iselin, NJ 08830
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 787129-01 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784246400000",
"number": "1730024563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 ROUTE 25A",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117871348",
"telephone_number": "631-862-3540",
"fax_number": "631-862-3604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 BELLE TERRE RD",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117771928",
"telephone_number": "631-862-3538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRINZ",
"first_name": "KYLER",
"middle_name": "NONE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-20",
"last_updated": "2026-07-17",
"certification_date": "2026-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NY",
"license": "787129",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "787129-01",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson, NY
- Richard Poveromo, LCSW, CCM, HEC-C
- Emily Hathorn Pozgay, NP
- Susan Prechtl-Loper, P.T., M.S.
- Cynthia A Price, NURSE PRACTITIONER
- Michelle P Price, MD
- Professional Occupational & Physical Therapy, PLLC
- Professional Orthopedic and Sports Physical Therapy, P.C.
- Professional Radiology PC
- Providers R'US LLC
- Regina Ann Provisiero, MA/CCC/SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.