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

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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 NameKenneth William Nissen
GenderMale
SpecialityNurse Practitioner
Experience12 Years
Location75 N Country Rd, Port Jefferson, New York
Accepts Medicare AssignmentsYes. 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.
IdentifierTypeStateIssuer
1043659980NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2200XNurse Practitioner - Adult Health 306258 (New York)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
John T Mather Memorial Hospital Of Port JeffersonPort jefferson, NYHospital
St Charles HospitalPort jefferson, NYHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
True North Medical Group Pc7012194806163

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 NameLong Island Bone And Joint
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740241884
PECOS PAC ID: 9638068406
Enrollment ID: O20040311000699
Entity NameNew York University
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1851456701
PECOS PAC ID: 1355232422
Enrollment ID: O20040329001569
Entity NameTrue North Medical Group Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice 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    
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
Laura Elizabeth Vinci, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 75 N Country Rd, Port Jefferson, NY 11777
Phone: 631-473-1320    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.