Kettly Cazaubon

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

345151 Issued in NY

Practice address

567 Miller Ave
Freeport, NY 11520-6310

Phone

(917) 548-8917

Fax

(949) 695-3560

NPI assigned

Oct 10, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcazaubon70599@direct.optum.com

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.

• M and M Psychiatric Nurse Practitioner Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
  • NPI 1336856467
  Medicare reassignment NPD
• New York City Health and Hospitals Corporation

  dba Jacobi Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1912549049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 MILLER AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115206310",
            "telephone_number": "917-548-8917",
            "fax_number": "949-695-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 MILLER AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115206310",
            "telephone_number": "917-548-8917",
            "fax_number": "949-695-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAZAUBON",
        "first_name": "KETTLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405633",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catholic Charities of the Diocese of Rockville Centre
• Catholic Charities of the Diocese of Rockville Centre
• Joseph A. Cattano, LCSW, PH.D
• Chelsea Elizabeth Cavallaro
• Catherine Marie Cavanagh
• Freddy Cedeno
• Olga Y Celleri-Pincus, DDS
• Antoniel Cenat
• Stephanie L. Cenat
• Danielle M Centofranchi, MSW

• Family Nurse Practitioner in Freeport, NY
• Providers in Freeport, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.

Verify at the official NPI Registry.