Individual provider Active NPI

Kevin Steven Pauta, FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1861114423
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F349996-01 Issued in NY
Practice address
4812 6TH Ave
Brooklyn, NY 11220-2004
Phone
(347) 938-5860
NPI assigned
Sep 12, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F349996-01 NY Primary

Addresses

Primary practice location

4812 6TH Ave
Brooklyn, NY 11220-2004

Mailing address

4812 6TH Ave
Brooklyn, NY 11220-2004
Phone (347) 938-5860

Other practice location 1

5721 5th Ave # 1
Brooklyn, NY 11220-3876
Phone (718) 439-1114

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
I20240507003605 NY Practitioner - Nurse Practitioner 0749621886 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F349996-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince May 1, 2024 Accepting new patients
New York University Current Accepting new patients
New York University CurrentSince May 1, 2024 Accepting new patients

Locations

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: kpauta639781@nyumc.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1861114423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 6TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202004",
            "telephone_number": "347-938-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 6TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202004",
            "telephone_number": "347-938-5860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5721 5th Ave # 1",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112203876",
            "country_code": "US",
            "telephone_number": "718-439-1114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUTA",
        "first_name": "KEVIN",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F349996-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.