Individual provider Active NPI

Kathryn Kirpan, MD

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1891778270
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
161916 Issued in NY
Practice address
305 Seguine Ave
Suite 1
Staten Island, NY 10309-3709
Phone
(718) 967-8300
Fax
(718) 967-8335
NPI assigned
Nov 21, 2005
Last updated
Mar 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 161916 NY Primary

Addresses

Primary practice location

305 Seguine Ave
Suite 1
Staten Island, NY 10309-3709

Mailing address

305 Seguine Ave
Suite 1
Staten Island, NY 10309-3709
Phone (718) 967-8300

Other identifiers 1

IdentifierTypeStateIssuer
02087387MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080513000008 NY Practitioner - General PracticePractitioner - Internal Medicine 7214006501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Richmond Primary Care Specialists PCGroup PAC ID 1658262308, 2 clinicians

Practice addresses (Care Compare)

305 Seguine Ave
Apt 1
Staten Island, NY 10309-3712
Phone (718) 967-8300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
161916NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vytaliz Medical Internal Medicine CurrentSince Feb 16, 2021 Accepting new patients
University Physicians Group P C Internal Medicine Past Accepting new patients
Staten Island University Hospital Past Accepting new patients

Locations

3 E Evergreen Rd
Ste 1017
New City, NY 10956
Phone (201) 565-2533

Interoperability endpoints

  • Direct secure messaging: kkirpan66239@northwell.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1891778270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SEGUINE AVE",
            "address_2": "SUITE 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093709",
            "telephone_number": "718-967-8300",
            "fax_number": "718-967-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SEGUINE AVE",
            "address_2": "SUITE 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093709",
            "telephone_number": "718-967-8300",
            "fax_number": "718-967-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRPAN",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "161916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02087387",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.