Individual provider Active NPI

Kristine Maria Mazzo, RPA-C

  • Physician Assistant
  • Forest Hills, NY
National Provider Identifier
1871841874
Registry record updated Aug 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015908 Issued in NY
Practice address
39 Winter St
Forest Hills, NY 11375-6037
Phone
(917) 974-2039
NPI assigned
Aug 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 015908 NY Primary

Addresses

Primary practice location

39 Winter St
Forest Hills, NY 11375-6037

Mailing address

39 Winter St
Forest Hills, NY 11375-6037
Phone (917) 974-2039

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
I20141006000479 NY Practitioner - Physician Assistant 1951521442 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

106 Charles Lindbergh Blvd
Uniondale, NY 11553-3632
Phone (866) 540-1163

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Winthrop Community Medical Affiliates, P.C. CurrentSince Nov 1, 2017 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients

Locations

700 Hicksville Rd
Ste 204
Bethpage, NY 11714
Phone (516) 576-5812

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

120 Mineola Blvd
Ste 100
Mineola, NY 11501
Phone (516) 663-2010

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: kmazzo@winthrop.direct.varian.com
  • Direct secure messaging: kristinemazzo@nslijmedgr.allscriptsdirect.net

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": "1345593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345593600000",
    "number": "1871841874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WINTER ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756037",
            "telephone_number": "917-974-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 WINTER ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756037",
            "telephone_number": "917-974-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZO",
        "first_name": "KRISTINE",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-22",
        "last_updated": "2012-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.