Kristan Probeck, RN, MS, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

30 305525 Issued in NY

Practice address

1743 North Ocean Ave
Medford, NY 11763

Phone

(631) 758-3100

NPI assigned

May 17, 2012

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

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: kristan.probeck@direct.stonybrookmedicine.edu
• Direct secure messaging: kprobeck137735@direct-chsli.net

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.

• CHS Physician Partners, PC

  • Interventional Cardiology Physician
  • Fresh Meadows, NY
  • NPI 1407089345
  Medicare reassignment Care Compare group NPD
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD
• CHS Physician Partners, PC

  • Family Medicine Physician
  • Bellmore, NY
  • NPI 1720334527
  NPD
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  NPD

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1780944363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICHOLLS RD",
            "address_2": "HSC 19-090 DEPARTMENT OF VASCULAR SURGERY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 NORTH OCEAN AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "11763",
            "telephone_number": "631-758-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBECK",
        "first_name": "KRISTAN",
        "name_prefix": "Ms.",
        "credential": "RN, MS, ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-17",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "544021",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "30 305525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Domenica Disalvo Potter, O.T.
• Tithiporn Premaskul, RPH
• Premier East Physical Medicine and Rehabilitation, PC
• Stephanie Principe, RN
• Priolo and Berns Chiropractic PLLC
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy, P.C.
• Professional Rehab P.T., P.C.
• Progressive Rehab Management Corporation
• Provident Health Partners Inc.

• Adult Health Nurse Practitioner in Medford, NY
• Providers in Medford, 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 Mar 1, 2016; 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.