Organization Active NPI

Kintinual Diagnostic Solutions LLC

  • Clinical Medical Laboratory
  • Roosevelt, NY
National Provider Identifier
1760134977
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
KINTINUAL DIAGNOSTIC SOLUTIONS LLC
Practice address
180 Grenada Ave
Roosevelt, NY 11575-1215
Phone
(516) 738-1408
NPI assigned
Jan 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Shanel BarrettNPI 1730427857
Title
Owner
Phone
(516) 738-1408

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

180 Grenada Ave
Roosevelt, NY 11575-1215

Mailing address

180 Grenada Ave
Roosevelt, NY 11575-1215
Phone (516) 738-1408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220318000883 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9739574278 Practice locations: Roosevelt, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1760134977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 GRENADA AVE",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751215",
            "telephone_number": "516-738-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 GRENADA AVE",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751215",
            "telephone_number": "516-738-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINTINUAL DIAGNOSTIC SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "SHANEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-738-1408"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.