NPIMap

Individual provider Active NPI

Kiran Achalla, NP

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1801900428
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
400661 Issued in 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
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 400661 NY Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040319000085 NY Practitioner - Nurse Practitioner 1052201266 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
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 YonkersGroup PAC ID 0547156176, 59 clinicians

Practice addresses (Care Compare)

275 N St
Harrison, NY 10528-1140
Phone (914) 967-6500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
400661NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince May 9, 2016 Accepting new patients
The Winifred Masterson Burke Rehabilitation Hospital CurrentSince Feb 1, 2021 Accepting new patients
Montefiore Medical Center CurrentSince May 9, 2016 Accepting new patients
St. Joseph's Hospital Yonkers Current Accepting new patients
The Winifred Masterson Burke Rehabilitation Hospital Current Accepting new patients
St Josephs Hospital Yonkers CurrentSince Sep 10, 2020 Accepting new patients
Winifred Masterson Burke Rehabilitation Hospital CurrentSince Feb 1, 2021 Accepting new patients
Winifred Masterson Burke Rehabilitation Hospital CurrentSince Feb 1, 2021 Accepting new patients
St.Vincent' Hospital Westchester Psych CurrentSince Sep 10, 2020 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) 597-2324

Networks

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

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801900428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 WILLOUGHBY ST",
            "address_2": "2ND FL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015290",
            "telephone_number": "212-645-8111",
            "fax_number": "212-645-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 E 9TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100095335",
            "telephone_number": "212-677-7999",
            "fax_number": "212-614-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHALLA",
        "first_name": "KIRAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "400661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.