Kellyann Patricia Civiletti, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

308012 Issued in NY

Practice address

403 E 34TH St FL 3
New York, NY 10016-4972

Phone

(212) 263-8134

NPI assigned

Oct 18, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

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

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chess Medicine PLLCGroup PAC ID 6406260736, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chess Medicine PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Montebello, NY
  • NPI 1699385021
  Medicare reassignment Care Compare group NPD
• Kings Physician Services, PC

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1083045090
  Medicare reassignment NPD
• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment NPD
• Kings Physician Services, PC

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1326698879
  NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD
• New York University Medical Center

  • Transplant Surgery Physician
  • New York, NY
  • NPI 1518957091
  NPD (past)

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

• NYU Langone Hospitals

  • Rehabilitation Hospital Unit
  • New York, NY
  • NPI 1275632895
  Care Compare affiliation
• NYU Langone Hospitals

  • Ambulance
  • Brooklyn, NY
  • NPI 1346614443

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • Mineola, NY
  • NPI 1427616002
  Care Compare affiliation
• NYU Langone Hospitals

  • Oncology Clinic/Center
  • New York, NY
  • NPI 1437230034

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1619341716
  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • New York, NY
  • NPI 1669578324
  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • New York, NY
  • NPI 1801992631
  Care Compare affiliation

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1770034373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 34TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E 34TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164972",
            "telephone_number": "212-263-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIVILETTI",
        "first_name": "KELLYANN",
        "middle_name": "PATRICIA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "646983",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aiz9014@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Antonia Ciunci
• Raquel Ciuro
• Kayhan Civelek, DDS MS
• Tiffany Marlene Civers
• Angelica Civetta, MA
• Cje Physical Therapy PLLC
• CKC Medical Office P.C.
• CKG Nurse Practitioner in Psychiatry PLLC
• CKM Medical PLLC
• Ckny Optical, Corp

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.