Individual provider Active NPI

Nina Kello

  • Rheumatology Physician
  • Great Neck, NY
National Provider Identifier
1750714614
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
285978 Issued in NY
Practice address
865 Northern Blvd Ste 302
Great Neck, NY 11021-5310
Phone
(516) 708-2550
NPI assigned
Aug 14, 2013
Last updated
Apr 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Rheumatology Physician 207RR0500X 285978 NY Primary

Addresses

Primary practice location

865 Northern Blvd Ste 302
Great Neck, NY 11021-5310

Mailing address

865 Northern Blvd Ste 302
Great Neck, NY 11021-5310
Phone (516) 708-2550

Other practice location 1

8268 164th St
Jamaica, NY 11432-1121
Phone (718) 883-4080

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190710002860 NY Practitioner - Rheumatology 4688919418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Aug 5, 2019 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 5, 2019 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

865 Northern Blvd
Ste 302
Great Neck, NY 11021
Phone (516) 570-4400

300 Community Dr
Manhasset, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: nkello11671@nychhc.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1750714614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 NORTHERN BLVD STE 302",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215310",
            "telephone_number": "516-708-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 NORTHERN BLVD STE 302",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215310",
            "telephone_number": "516-708-2550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8268 164th St",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114321121",
            "country_code": "US",
            "telephone_number": "718-883-4080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLO",
        "first_name": "NINA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "285978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.