Individual provider Active NPI

Kayla Darienzo, FNP

  • Pediatric Gastroenterology Physician
  • New Hyde Park, NY
National Provider Identifier
1780567974
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
357282 Issued in NY
Practice address
1991 Marcus Ave Ste M100
New Hyde Park, NY 11042-2062
Phone
(516) 472-3650
NPI assigned
Jul 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 357282 NY Primary

Addresses

Primary practice location

1991 Marcus Ave Ste M100
New Hyde Park, NY 11042-2062

Mailing address

1116 5TH Ave
East Northport, NY 11731-2532
Phone (631) 741-4114

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022000248 NY Practitioner - Nurse Practitioner 4486142452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
357282NYMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Sep 2, 2025 Accepting new patients

Locations

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

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

1991 Marcus Ave
Ste M100
New Hyde Park, NY 11042
Phone (516) 472-3650

300 Community Dr
Plandome, NY 11030

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1780567974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 5TH AVE",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312532",
            "telephone_number": "631-741-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE STE M100",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422062",
            "telephone_number": "516-472-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARIENZO",
        "first_name": "KAYLA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "357282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.