NPIMap

Individual provider Active NPI

Kristina Noelle Kassis, PA

  • Medical Physician Assistant
  • Monroe, NY
National Provider Identifier
1932757069
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
026160 Issued in NY
Practice address
855 State Route 17M
Monroe, NY 10950-1600
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
Sep 2, 2019
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 026160 NY Primary

Addresses

Primary practice location

855 State Route 17M
Monroe, NY 10950-1600

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4057
Phone (845) 703-6999

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kristina.kassispac.p1@direct.crystalrun.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210122000744 NY Practitioner - Physician Assistant 2062826696 Reassigns benefits to 1 organization
I20220425000246 PA Practitioner - Physician Assistant 2062826696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbia Memorial HospitalGroup PAC ID 5092709410, 171 clinicians

Practice addresses (Care Compare)

159 Jefferson HTS
Catskill, NY 12414-1237
Phone (518) 828-7601

2827 US Route 9
Valatie, NY 12184-0785
Phone (518) 828-8051

345 State Route 296
Hensonville, NY 12439-5109
Phone (518) 828-8051

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Columbia Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Columbia Memorial Hospital Past Accepting new patients

Locations

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

2827 US Highway 9
Valatie, NY 12184
Phone (518) 828-7601

Interoperability endpoints

  • Direct secure messaging: kkassis99720@albanymed.direct-ci.com

Organizations & group practices 5

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 8

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": "1567382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1932757069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414057",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 STATE ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501600",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSIS",
        "first_name": "KRISTINA",
        "middle_name": "NOELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-02",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "026160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristina.kassispac.p1@direct.crystalrun.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 State Route 17M",
            "city": "Monroe",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109501600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

Verify at the official NPI Registry.