Kerri Ann Petitpain

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

333951 Issued in NY

Practice address

18 Scott LN
Manorville, NY 11949-2624

Phone

(631) 905-6890

Fax

(888) 920-2296

NPI assigned

Feb 4, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

State University of New York at Stony Brook, School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tender Loving Care, an Amedisys Company Home health agency, Medford, NY, CCN 337260
• Wellbound Home health agency, Brooklyn, NY, CCN 337450
• Centerwell Home Health Home health agency, Hauppauge, NY, CCN 337232
• VNS & Hospice of Suffolk Inc Chha Home health agency, Northport, NY, CCN 337014

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Kerri Petitpain Medical

  • Family Nurse Practitioner
  • Manorville, NY
  • NPI 1184253262
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• QC-Medi New York, Inc.

  • Home Health Agency
  • Hauppauge, NY
  • NPI 1376575977
  Care Compare affiliation Name & address match
• Tender Loving Care Health Care Services of Nassau Suffolk, LLC

  • Home Health Agency
  • Medford, NY
  • NPI 1699715961
  Care Compare affiliation
• Visiting Nurse Service and Hospice of Suffolk Inc.

  • Home Health Agency
  • Northport, NY
  • NPI 1356494637
  Care Compare affiliation
• Visiting Nurse Service and Hospice of Suffolk, Inc

  • Home Health Agency
  • Northport, NY
  • NPI 1770580516
  Care Compare affiliation
• Wellbound LLC

  • Home Health Agency
  • Brooklyn, NY
  • NPI 1518305572
  Care Compare affiliation

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1760621304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SCOTT LN",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492624",
            "telephone_number": "631-764-5561",
            "fax_number": "503-386-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SCOTT LN",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492624",
            "telephone_number": "631-905-6890",
            "fax_number": "888-920-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETITPAIN",
        "first_name": "KERRI",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toni J Peeling, R.N.
• Colleen Marie Pennica
• Lisa Marie Perrino, R.N.
• Jessica Petchonka, PA-C
• Debra Peters, CASAC-T, CARC
• Karen Diers Piddoubny, LBA
• PLC Optical Corp
• Krystal A Porfidia
• Pure Dental of Long Island PC
• Nancy April Quintilian

• Family Nurse Practitioner in Manorville, NY
• Providers in Manorville, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.