KELLY SASS (NPI# 1659981470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659981470 |
Entity Type | Individual |
Full Name | KELLY SASS |
Practice Address |
11 Route 111 Smithtown NY 11787-3754 |
Practice Telephone | 6319208351 |
Mailing Telephone | 6319208351 |
Enumeration Date | 2020-08-06 |
Last Update Date | 2020-11-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163W00000X | Registered Nurse | 667614 | NY | Nursing Service Providers |
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
403199 | NY | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
11 ROUTE 111 |
City | SMITHTOWN |
State | NY |
Zip Code | 11787-3754 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841200011 | Tara Marie Brunswick | Social Worker | 11 Route 111, Smithtown, NY 11787-3712 | 2006-08-09 |
1528667565 | Aleah Sophia Innis | Student in an Organized Health Care Education/Training Program | 11 Route 111, Smithtown, NY 11787-3754 | 2020-10-21 |
1174120018 | Andrea Lynn Crisci | Student in an Organized Health Care Education/Training Program | 11 Route 111, Smithtown, NY 11787-3754 | 2020-10-05 |
1811504491 | Katie Hodgson | Student in an Organized Health Care Education/Training Program | 11 Route 111, Smithtown, NY 11787-3754 | 2020-09-28 |
1588298731 | New Horizons | Social Worker | 11 Route 111, Smithtown, NY 11787-3754 | 2020-02-26 |
1972135481 | April Marie Lee | Registered Nurse | 11 Route 111, Smithtown, NY 11787-3754 | 2020-02-12 |
1538791702 | Talia Renee Hughes | Student in an Organized Health Care Education/Training Program | 11 Route 111, Smithtown, NY 11787-3754 | 2020-02-06 |
1861032260 | Maryclare Anderson | Case Manager/Care Coordinator | 11 Route 111, Smithtown, NY 11787-3754 | 2020-01-14 |
1770123184 | Guillermo F Sandoval | Social Worker | 11 Route 111, Smithtown, NY 11787-3754 | 2020-01-14 |
1437799509 | Dani Mason | Case Manager/Care Coordinator | 11 Route 111, Smithtown, NY 11787-3754 | 2020-01-07 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
Find all providers in zip 11787 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306249735 | Janine Desimone | Nurse Practitioner | 20 Gilbert Ave Ste 202, Smithtown, NY 11787 | 2014-09-30 |
1679871032 | Bernadette Barron | Nurse Practitioner | 1 Cresthill Pl, Smithtown, NY 11787-3703 | 2011-03-09 |
1679606784 | Lorraine Ricciardi Golden | Nurse Practitioner | 99 Hollywood Dr., Smithtown, NY 11787 | 2007-03-14 |
1366507345 | Barbara Ruth Sprung | Nurse Practitioner | 412 Sunset Ln, Smithtown, NY 11787-4422 | 2006-12-27 |
1326052333 | Catherine Zillmann | Nurse Practitioner | 363 Route 111 Ste 103, Smithtown, NY 11787-4750 | 2006-07-27 |
1578513107 | Catherine Bridget O'brien | Nurse Practitioner | 637 Veterans Hwy, Smithtown, NY 11787-4309 | 2006-05-12 |
1194337253 | Eva Dziergowska | Nurse Practitioner | 363 Route 111, Smithtown, NY 11787-4756 | 2020-08-20 |
1992320725 | Thao Nguyen Nurse Practitioner In Psychiatry PC | Nurse Practitioner | 88 Terry Rd, Smithtown, NY 11787-3811 | 2020-06-08 |
1942864640 | Lauren Tita | Nurse Practitioner | 222 E Middle Country Rd Ste 310, Smithtown, NY 11787-2814 | 2019-04-28 |
1518452390 | Christina Stern | Nurse Practitioner | 222 E Middle Country Rd Ste 210, Smithtown, NY 11787-2814 | 2018-06-25 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.