KERRI PETITPAIN MEDICAL
NPI 1184253262
Nurse Practitioner - Family in Manorville, NY
About Kerri Petitpain Medical NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KERRI PETITPAIN MEDICAL (NPI 1184253262) is a healthcare organization registered as a family in Manorville, New York and active in the NPI registry since April 2020. The organization lists Kerri Ann Petitpain, Practitioner/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kerri Petitpain Medical is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Kerri Petitpain Medical, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kerri Petitpain Medical's NPI number?
The NPI number for Kerri Petitpain Medical is 1184253262. It was assigned to this organization in the NPPES registry on April 2, 2020.
Where is Kerri Petitpain Medical located?
Kerri Petitpain Medical is located at 18 Scott Ln, Manorville, NY 11949. The listed phone number is (631) 905-6890.
What is Kerri Petitpain Medical's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kerri Petitpain Medical enrolled in Medicare?
Yes. Kerri Petitpain Medical is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kerri Petitpain Medical?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Kerri Petitpain Medical. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Kerri Petitpain Medical was last updated on April 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kerri Petitpain Medical · NPI 1184253262
Family organization in Manorville, New York. Organization record, active in the CMS NPPES registry since April 2, 2020.
## Identity
- **NPI:** 1184253262 (Entity type: Organization)
- **Enumerated:** April 2, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Also known as:** Kerri Petitpain Medical (Other Name)
- **Organization subpart:** No
- **Authorized official:** Kerri Petitpain, PRACTITIONER/OWNER
## Practice location
- **Address:** 18 SCOTT LN, Manorville, NY 11949-2624
- **Phone:** (631) 905-6890 · **Fax:** (888) 920-2296
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 2, 2020
- **Other identifiers:** Medicaid 03410419 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1184253262) · Data from the CMS NPPES public registry.