Active NPI
Kristina Joan Denenkamp, PA
- Physician Assistant
- Miller Place, NY
National Provider Identifier
1811396096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 017818-1
- Practice address
- 38 Manor Dr
Miller Place, NY 11764-1323 - Phone
- (631) 681-9789
- NPI assigned
- Aug 14, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 017818-1 | NY | Primary |
Addresses
Primary practice location
38 Manor Dr
Miller Place, NY 11764-1323
Mailing address
38 Manor Dr
Miller Place, NY 11764-1323
Phone (631) 681-9789
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017818 | NY | MD | Clinical Psychologist |
| 017818-1 | NY | MD | Physician Assistant |
Interoperability endpoints
- kdenenkamp674656@nychhc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1811396096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 MANOR DR",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117641323",
"telephone_number": "631-681-9789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 MANOR DR",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117641323",
"telephone_number": "631-681-9789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENENKAMP",
"first_name": "KRISTINA",
"middle_name": "JOAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-14",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "017818-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miller Place, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.