Individual provider Active NPI

Krishna Sanjeev Kakkera, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1861170631
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
358500 Issued in NY
Practice address
1371 Seabury Ave
Bronx, NY 10461-3651
Phone
(718) 294-6200
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 358500 NY Primary
Registered Nurse 163W00000X 856353 NY

Addresses

Primary practice location

1371 Seabury Ave
Bronx, NY 10461-3651

Mailing address

1371 Seabury Ave
Bronx, NY 10461-3651
Phone (718) 294-6200

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
I20260410001422 NY Practitioner - Nurse Practitioner 0941775571 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
House Call Medical Services of New York, PLLCGroup PAC ID 2264517754, 162 clinicians

Practice addresses (Care Compare)

1371 Seabury Ave
Bronx, NY 10461-3651
Phone (718) 618-0401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
856353NYMDRegistered Nurse
358500NYMDFamily Nurse Practitioner

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1861170631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 SEABURY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613651",
            "telephone_number": "718-294-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 SEABURY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613651",
            "telephone_number": "718-294-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKKERA",
        "first_name": "KRISHNA",
        "middle_name": "SANJEEV",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "358500",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "856353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.