Individual provider Active NPI

Kelly Ann Levine, P.A.

  • Physician Assistant
  • Mineola, NY
National Provider Identifier
1730475278
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009741-1 Issued in NY
Practice address
200 Old Country Road
Mineola, NY 11501
Phone
(516) 294-5440
Fax
(516) 294-1206
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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 009741-1 NY Primary

Addresses

Primary practice location

200 Old Country Road
Mineola, NY 11501

Mailing address

200 Old Country Rd
Suite 365
Mineola, NY 11501-4235
Phone (516) 294-5440

Other names 1

  • Kelly Ann Burke Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klevine222089@nyumc.direct-ci.com

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
I20040709000712 NY Practitioner - Physician Assistant 6002891520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, New York, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

297 Mineola Blvd
Mineola, NY 11501-1502
Phone (516) 294-1377

70 E Sunrise Hwy
Valley Stream, NY 11581-1233
Phone (516) 536-5656

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009741-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Winthrop Community Medical Affiliates, P.C. CurrentSince Nov 1, 2017 Accepting new patients

Locations

700 Hicksville Rd
Ste 204
Bethpage, NY 11714
Phone (516) 576-5812

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

120 Mineola Blvd
Ste 320
Mineola, NY 11501
Phone (516) 663-3300

200 Old Country Rd
Mineola, NY 11501
Phone (516) 408-4900

120 Mineola Blvd
Ste 100
Mineola, NY 11501
Phone (516) 663-2010

200 Old Country Rd
Ste 365
Mineola, NY 11501
Phone (516) 294-5440

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

70 E Sunrise Hwy
Ste 515
Valley Stream, NY 11581
Phone (516) 536-5656

Networks

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

Interoperability endpoints

  • Direct secure messaging: klevine@winthrop.direct.varian.com

Organizations & group practices 3

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 7

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1730475278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD",
            "address_2": "SUITE 365",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014235",
            "telephone_number": "516-294-5440",
            "fax_number": "516-294-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY ROAD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "11501",
            "telephone_number": "516-294-5440",
            "fax_number": "516-294-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009741-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klevine222089@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "200 Old Country Road",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BURKE",
            "middle_name": "ANN",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.