Active NPI
Kelly Yip
- Adult Health Nurse Practitioner
- Riverhead, NY
National Provider Identifier
1962233775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F311493-01
- Practice address
- 877 E Main St Ste 106
Riverhead, NY 11901-2521 - Phone
- (631) 727-0660
- NPI assigned
- Aug 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F311493-01 | NY | Primary |
Addresses
Primary practice location
877 E Main St Ste 106
Riverhead, NY 11901-2521
Mailing address
24 Pleasant Ave
Plainview, NY 11803-1430
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
77 Medford Ave
Patchogue, NY 11772-1281
Phone (631) 758-1910
877 E Main St
Suite 106
Riverhead, NY 11901-2521
Phone (631) 727-0660
Hospital & facility affiliations
- Suny/Stony Brook University Hospital
- NYU Langone Hospitals
- Long Island Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F311493-01 | NY | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients |
Locations
700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
877 E Main St
Ste 106
Riverhead, NY 11901
Phone (631) 727-0660
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- kyip669029@nyumc.direct-ci.com
Organizations & group practices 2
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.
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 15
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Patchogue, NY
- NPI 1013724061
Hospital
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
-
- General Acute Care Hospital
- Patchogue, NY
- NPI 1831910355
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1962233775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 PLEASANT AVE",
"city": "PLAINVIEW",
"state": "NY",
"postal_code": "118031430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 E MAIN ST STE 106",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119012521",
"telephone_number": "631-727-0660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YIP",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-13",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F311493-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverhead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.