Individual provider Active NPI

Kristen Tooma, MSN, APRN, AGNCNP-BC

  • Adult Health Nurse Practitioner
  • Lake Grove, NY
National Provider Identifier
1871489864
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311343 Issued in NY
Practice address
4 Smith Haven Mall Ste 110
Lake Grove, NY 11755-1219
Phone
(631) 444-6270
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311343 NY Primary

Addresses

Primary practice location

4 Smith Haven Mall Ste 110
Lake Grove, NY 11755-1219

Mailing address

24 Research Way Ste 500
East Setauket, NY 11733-3470

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
I20250919001575 NY Practitioner - Nurse Practitioner 3577067743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

24 Research Way
Suite 500
East Setauket, NY 11733-3470
Phone (631) 444-6270

P O Box
Suite 1554
Stony Brook, NY 11790-0989

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
311343NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Urology, University Faculty Practice Corporation CurrentSince Sep 8, 2025 Accepting new patients

Locations

4 Smith Haven Mall
Ste 110
Lake Grove, NY 11755

24 Research Way
Ste 500
Setauket, NY 11733
Phone (631) 444-2209

Networks

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

Organizations & group practices 1

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 6

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1871489864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 RESEARCH WAY STE 500",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SMITH HAVEN MALL STE 110",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551219",
            "telephone_number": "631-444-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOMA",
        "first_name": "KRISTEN",
        "credential": "MSN, APRN, AGNCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

Verify at the official NPI Registry.