Kenneth William Nissen, ANP in Port Jefferson, NY

Kenneth William Nissen, ANP is a medicare enrolled "Nurse Practitioner - Adult Health" in Port Jefferson, New York. He went to State University Of New York At Stony Brook, School Of Medicine and graduated in 2012 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice True North Medical Group Pc and his current practice location is 75 N Country Rd, Port Jefferson, New York. You can reach out to his office (for appointments etc.) via phone at (631) 476-2786.

Kenneth William Nissen is licensed to practice in New York (license number 306258) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1043659980.

Contact Information

	Kenneth William Nissen, ANP
	75 N Country Rd, Port Jefferson, NY 11777-2119
	(631) 476-2786
	Not Available

Map and Direction

Provider's Profile

Full Name	Kenneth William Nissen
Gender	Male
Speciality	Nurse Practitioner
Experience	12 Years
Location	75 N Country Rd, Port Jefferson, New York
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kenneth William Nissen attended and graduated from State University Of New York At Stony Brook, School Of Medicine in 2012

NPI Data:

NPI Number: 1043659980
Provider Enumeration Date: 06/24/2013
Last Update Date: 06/24/2013

Medicare PECOS Information:

PECOS PAC ID: 2264667633
Enrollment ID: I20131022000044

Medical Identifiers

Medical identifiers for Kenneth William Nissen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043659980	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	306258 (New York)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
John T Mather Memorial Hospital Of Port Jefferson	Port jefferson, NY	Hospital
St Charles Hospital	Port jefferson, NY	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
True North Medical Group Pc	7012194806	161

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kenneth William Nissen allows following entities to bill medicare on his behalf.

Entity Name	Long Island Bone And Joint
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740241884 PECOS PAC ID: 9638068406 Enrollment ID: O20040311000699

Entity Name	New York University
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851456701 PECOS PAC ID: 1355232422 Enrollment ID: O20040329001569

Entity Name	True North Medical Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659883486 PECOS PAC ID: 7012194806 Enrollment ID: O20171229000536

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth William Nissen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kenneth William Nissen, ANP 25 Wiltshire Dr, Commack, NY 11725-3330 Ph: (516) 521-0456	Kenneth William Nissen, ANP 75 N Country Rd, Port Jefferson, NY 11777-2119 Ph: (631) 476-2786

Reviews and Comments

Nurse Practitioner Nurses in Port Jefferson, NY

Ms. Janice Fleischman Eaton, ANP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 23 Old Post Road East, Port Jefferson, NY 11777 Phone: 631-928-7999
Katlyn Ann Conville, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 75 N Country Rd, Port Jefferson, NY 11777 Phone: 631-686-2565
Joanne F Angstadt, ACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 200 Belle Terre Road, Port Jefferson, NY 11733 Phone: 631-675-2462
Ms. Christine Julia Mckeon, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 Highlands Blvd, Port Jefferson, NY 11777 Phone: 631-473-3877
Joan L Nathan, A.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 120 N Country Rd, Port Jefferson, NY 11777 Phone: 631-928-4586
Genine Schwinge, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 75 N Country Rd, Port Jefferson, NY 11777 Phone: 631-473-1320 Fax: 631-686-7653

Kenneth William Nissen, ANP - Medicare Nurse Practitioner in Port Jefferson, NY