KATHLEEN RENE NP
NPI 1053947317
Nurse Practitioner - Adult Health in Southold, NY

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LA2200X and a focus in Adult Health.

Active since March 19, 2020PECOS Enrolled

57190 MAIN RD, SOUTHOLD, NY 11971(631) 626-1006 Get Directions Write a Review

NPPES record last updated: March 19, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kathleen Rene Np NPPES

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

KATHLEEN RENE NP (NPI 1053947317) is an individual adult health provider in Southold, New York, licensed in New York (309280) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053947317

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameKATHLEEN RENECredential: NP

Location Address57190 MAIN RDSouthold, NY 11971-4750

Mailing Address22 Pine Cone LnIslandia, NY 11749-5512

Phone(631) 626-1006

Sole ProprietorNo

Enumeration DateMarch 19, 2020

NPPES CertifiedMarch 19, 2020

✔ NPI 1053947317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · 309280

57190 MAIN RD, Southold, NY 11971

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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 (PECOS)

Kathleen Rene Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11971 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.