Individual provider Active NPI

Diana Kravtsov, FNP

  • Family Nurse Practitioner
  • Kingston, NY
National Provider Identifier
1962057596
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F343979 Issued in NY
Practice address
211 Hurley Ave
Kingston, NY 12401-2400
Phone
(845) 339-2804
Fax
(845) 338-5982
NPI assigned
Aug 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F343979 NY Primary

Addresses

Primary practice location

211 Hurley Ave
Kingston, NY 12401-2400

Mailing address

211 Hurley Ave
Kingston, NY 12401-2400
Phone (845) 340-1185

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190926000173 NY Practitioner - Nurse Practitioner 5496085987 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F343979NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Valley Medical Health Choices, P.C. CurrentSince Mar 1, 2020 Accepting new patients
Hurley Ave Family Med PLLC CurrentSince Sep 16, 2019 Accepting new patients
Hurley Avenue Family Medicine Past Accepting new patients

Locations

146 Jefferson Hts
Catskill, NY 12414
Phone (518) 943-3415

211 Hurley Ave
Kingston, NY 12401
Phone (845) 339-2804

374 Violet Ave
Poughkeepsie, NY 12601
Phone (845) 240-7555

3190 Route 9W
Saugerties, NY 12477
Phone (845) 246-2836

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.

NPI Registry JSON

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1962057596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HURLEY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012400",
            "telephone_number": "845-340-1185",
            "fax_number": "845-338-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 HURLEY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012400",
            "telephone_number": "845-339-2804",
            "fax_number": "845-338-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVTSOV",
        "first_name": "DIANA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F343979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.