Individual provider Active NPI

Krystal Kane, P.A.

  • Vascular Surgery Physician
  • Huntington, NY
National Provider Identifier
1861779571
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
015329 Issued in NY
Practice address
175 East Main Street
Huntington, NY 11743
Phone
(631) 470-1460
NPI assigned
Nov 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Vascular Surgery Physician 2086S0129X 015329 NY Primary

Addresses

Primary practice location

175 East Main Street
Huntington, NY 11743

Mailing address

175 East Main Street
Huntington, NY 11743
Phone (631) 470-1460

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
I20120420000580 NY Practitioner - Physician Assistant 6901067727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical Group at Huntington PCGroup PAC ID 7214357086, 46 clinicians

Practice addresses (Care Compare)

2001 Marcus Ave
Suite S50
New Hyde Park, NY 11042-1039
Phone (516) 328-9800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
015329NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: krystalkane@nslijmedgr.allscriptsdirect.net
  • Direct secure messaging: krystal.sposito@direct.stonybrookmedicine.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1861779571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 EAST MAIN STREET",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "11743",
            "telephone_number": "631-470-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 EAST MAIN STREET",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "11743",
            "telephone_number": "631-470-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "KRYSTAL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "015329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.