Kim Axelrad, NPP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F4015421 Issued in NY

Practice address

3600 Route 112
Coram, NY 11727-4116

Phone

(631) 920-8500

NPI assigned

May 15, 2013

Last updated

May 15, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Welllife Network IncGroup PAC ID 0749179570, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Welllife Network Inc.,

  • Clinic/Center
  • Huntington, NY
  • NPI 1932125721
  Medicare reassignment Care Compare group NPD
• Welllife Network Inc

  • Case Management Agency
  • Elmont, NY
  • NPI 1508012816
  NPD
• Welllife Network Inc.

  • Case Management Agency
  • Coram, NY
  • NPI 1386817906
  NPD (past)

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1942646104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274116",
            "telephone_number": "631-920-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274116",
            "telephone_number": "631-920-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXELRAD",
        "first_name": "KIM",
        "name_prefix": "Ms.",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F4015421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Armstrong
• Asad Butt MD PLLC
• Frances Atanasio I, B.A.
• Rene Antoinette Atkinson, LPN
• Milagros Atz
• Alisha Babar
• Michael Andre Bacchus, LPN
• Parker Robert Bachisin
• Nia Bailey, LPN
• Charles A Baker, DDS

• Psychiatric/Mental Health Nurse Practitioner in Coram, NY
• Providers in Coram, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.