Active NPI
Stefanie Beth Kagan
- Pediatrics Physician
- Forest Hills, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 309505
- Practice address
- 10615 Queens Blvd Apt 5M
Forest Hills, NY 11375-4375 - Phone
- (718) 930-6616
- NPI assigned
- Apr 10, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 309505 | NY | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
10615 Queens Blvd Apt 5M
Forest Hills, NY 11375-4375
Mailing address
10615 Queens Blvd Apt 5M
Forest Hills, NY 11375-4375
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309505 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Lij, Urgent Care, P.C. | Current | Accepting new patients | |
| PM Pediatrics PC | Pediatrics | Past | Accepting new patients |
| PM Pediatrics of Mamaroneck | Past | Accepting new patients |
Locations
5555 Glenridge Connector
Ste 700
Sandy Springs, GA 30342
Phone (470) 567-7780
5828 99th St
Flushing, NY 11368
Phone (718) 502-9867
71 Forest Ave
Glen Cove, NY 11542
Phone (347) 493-2941
1332 Peninsula Blvd
Hewlett, NY 11557
Phone (516) 531-6130
377 S Oyster Bay Rd
Plainview, NY 11803
Phone (516) 537-9061
377 S Oyster Bay Rd
#13202
Plainview, NY 11803
Phone (516) 537-9061
Interoperability endpoints
- stefanie.kagan@ghuc.eclinicaldirectplus.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 and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Rockville Centre, NY
- NPI 1679970891
-
- Urgent Care Clinic/Center
- Mamaroneck, NY
- NPI 1073645180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747180800000",
"number": "1891292546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10615 QUEENS BLVD APT 5M",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113754375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10615 QUEENS BLVD APT 5M",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113754375",
"telephone_number": "718-930-6616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAGAN",
"first_name": "STEFANIE",
"middle_name": "BETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-10",
"last_updated": "2025-05-14",
"certification_date": "2025-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "309505",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.