Active NPI
Kristen Quintana, APRN
- Pediatric Nurse Practitioner
- Smithtown, NY
National Provider Identifier
1740688878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 383337
- Practice address
- 14 Bellemeade Ave
Smithtown, NY 11787-1857 - Phone
- (631) 265-5300
- NPI assigned
- Dec 5, 2014
- Last updated
- Jun 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 383337 | NY | Primary |
| Pediatric Registered Nurse | 163WP0200X | 691850-1 | NY | |
| Pediatric Registered Nurse | 163WP0200X | 9564092 | FL |
Addresses
Primary practice location
14 Bellemeade Ave
Smithtown, NY 11787-1857
Mailing address
15812 Heron Hill St
Clermont, FL 34714-4927
Phone (631) 790-0155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9564092 | FL | MD | Pediatric Registered Nurse |
| 691850-1 | NY | MD | Pediatric Registered Nurse |
| 383337 | NY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christian Nursing Registry, Inc. | Past | Accepting new patients | |
| Christian Nursing Registry Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Smithtown, NY
- NPI 1942587621
-
- Home Health Agency
- Smithtown, NY
- NPI 1912038274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718150400000",
"number": "1740688878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15812 HERON HILL ST",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347144927",
"telephone_number": "631-790-0155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 BELLEMEADE AVE",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117871857",
"telephone_number": "631-265-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINTANA",
"first_name": "KRISTEN",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-05",
"last_updated": "2024-06-12",
"certification_date": "2024-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "383337",
"primary": true
},
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "NY",
"license": "691850-1",
"primary": false
},
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "FL",
"license": "9564092",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.