Kiran Achalla, NP
Individual provider Active NPI Nurse Practitioner · New York, NY
NPI 1801900428 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801900428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 400661 (NY)
- Practice address
- 743 E 9TH St
New York, NY 10009-5335 - Phone
- (212) 677-7999
- Fax
- (212) 614-1844
- NPI assigned
- Aug 19, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St Joseph'S Hospital Yonkers
Practice addresses (Care Compare)
275 N St
Harrison, NY 10528-1140
Phone (914) 967-6500
Hospital & facility affiliations
- St Joseph'S Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040319000085 | NY | Practitioner - Nurse Practitioner | 1052201266 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 400661 | NY | MD | Nurse Practitioner |
Practice roles (9 of 12)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current |
Accepting new patients | |
| Winifred Masterson Burke Rehabilitation Hospital | Current |
Accepting new patients | |
| St.Vincent' Hospital Westchester Psych | Current |
Accepting new patients | |
| St. Joseph'S Hospital Yonkers | Current | Accepting new patients | |
| Winifred Masterson Burke Rehabilitation Hospital | Current |
Accepting new patients | |
| The Winifred Masterson Burke Rehabilitation Hospital | Current |
Accepting new patients | |
| St Josephs Hospital Yonkers | Current |
Accepting new patients | |
| The Winifred Masterson Burke Rehabilitation Hospital | Current | Accepting new patients | |
| Montefiore Medical Center | Current |
Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
275 North St
Harrison, NY 10528
Phone (914) 925-5211
785 Mamaroneck Ave
White Plains, NY 10605
Phone (914) 597-2257
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 400661 | NY | Yes |
Addresses
Primary practice location
743 E 9TH St
New York, NY 10009-5335
Mailing address
57 Willoughby St
2ND FL
Brooklyn, NY 11201-5290
Phone (212) 645-8111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LICENSE NUMBER | Other | NY | 400661 |
Other providers in New York, NY
- Peter Acevedo
- Ramon E Acevedo
- Samantha Acevedo
- Yamil Acevedo
- Yesenia Acevedo
- Sandra Achampong
- Keya Acharya
- Sajan Acharya
- Suchitra S Acharya
- Werner Sebastian Achatz
All providers in New York, NY · Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.