KATLYN ANN CONVILLE ANTHONY NP
NPI 1023679503
Nurse Practitioner - Family in Port Jefferson, NY

Q: What is Katlyn Anthony's NPI number?

The NPI number for Katlyn Anthony is 1023679503. It was assigned to this individual provider in the NPPES registry on June 25, 2019.

Q: What is Katlyn Anthony's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Katlyn Anthony was last updated on December 22, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 25, 2019PECOS EnrolledAccepts Medicare Assignment

75 N COUNTRY RD, PORT JEFFERSON, NY 11777(631) 686-2565 Get Directions Write a Review

NPPES record last updated: December 22, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Katlyn Ann Conville Anthony Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATLYN ANN CONVILLE ANTHONY NP (NPI 1023679503) is an individual family provider in Port Jefferson, New York, licensed in New York (344632) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, is affiliated with John T Mather Memorial Hospital Of Port Jefferson, and is a graduate of State University Of New York At Stony Brook, School Of Medicine (2019).

NPPES Registry Identity

NPI1023679503

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKATLYN ANN CONVILLE ANTHONYCredential: NP

Location Address75 N COUNTRY RDPort Jefferson, NY 11777-2119

Mailing Address75 N Country RdPort Jefferson, NY 11777-2119

Phone(631) 686-2565

Sole ProprietorNo

Medical School CMSState University Of New York At Stony Brook, School Of MedicineGraduated 2019

Enumeration DateJune 25, 2019

Last NPPES UpdateDecember 22, 2025

NPPES CertifiedDecember 22, 2025

✔ NPI 1023679503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · 344632

75 N COUNTRY RD, Port Jefferson, NY 11777

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Katlyn Ann Conville Anthony Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072842681

PECOS Enrollment IDI20190906002830

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

160 services81 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

51 services51 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

14 services14 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

John T Mather Memorial Hospital Of Port Jefferson

Acute Care Hospitals · Port Jefferson, NY

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330185

Location75 North Country RoadPort Jefferson, NY 11777 · Suffolk County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11777 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTINA CATHERINE MELLONE DO

Student in an Organized Health Care Education/Training Program