Individual provider Active NPI

Kristen Lackaye, NP

  • Adult Health Nurse Practitioner
  • Poughkeepsie, NY
National Provider Identifier
1801349501
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
307889 Issued in NY
Practice address
21 Reade PL
Suite 3100
Poughkeepsie, NY 12601-3912
Phone
(845) 214-1800
NPI assigned
Jul 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 307889 NY Primary

Addresses

Primary practice location

21 Reade PL
Suite 3100
Poughkeepsie, NY 12601-3912

Mailing address

21 Reade PL
Suite 3100
Poughkeepsie, NY 12601-3912
Phone (845) 214-1800

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
I20161024000276 NY Practitioner - Nurse Practitioner 0941588164

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1801349501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 READE PL",
            "address_2": "SUITE 3100",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013912",
            "telephone_number": "845-214-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 READE PL",
            "address_2": "SUITE 3100",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013912",
            "telephone_number": "845-214-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKAYE",
        "first_name": "KRISTEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.