KAZELL ANN PENALOSA FNP-BC
NPI 1215695077
Nurse Practitioner in Cornwall, NY
About Kazell Ann Penalosa Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KAZELL ANN PENALOSA FNP-BC (NPI 1215695077) is an individual nurse practitioner in Cornwall, New York, licensed in New York (347643) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS, is affiliated with St Luke's Cornwall Hospital, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kazell Ann Penalosa Fnp-bc 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.
Medicare Billing Reassignment
Medicare enrollment records show Kazell Ann Penalosa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Cornwall, NY 12518
- Reassigned Medicare billing, New York enrollment
- 79 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Luke's Cornwall Hospital
Acute Care Hospitals · Newburgh, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 12518 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CORNWALL, NY 12518
CORNWALL, NY 12518
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 Kazell Ann Penalosa's NPI number?
The NPI number for Kazell Ann Penalosa is 1215695077. It was assigned to this individual provider in the NPPES registry on November 29, 2021.
Where is Kazell Ann Penalosa located?
Kazell Ann Penalosa practices at 19 Laurel Ave, Cornwall, NY 12518. The listed phone number is (845) 534-7711.
What is Kazell Ann Penalosa's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Kazell Ann Penalosa enrolled in Medicare?
Yes. Kazell Ann Penalosa is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kazell Ann Penalosa's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kazell Ann Penalosa reassigns Medicare benefits to Hudson Vista Medical,pc (Cornwall, NY). The 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 Kazell Ann Penalosa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kazell Ann Penalosa affiliated with any hospitals?
According to CMS data, Kazell Ann Penalosa is affiliated with St Luke's Cornwall Hospital.
When was this NPI record last updated?
The NPPES record for Kazell Ann Penalosa was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Kazell Ann Penalosa, FNP-BC · NPI 1215695077
Nurse Practitioner physician in Cornwall, New York. Individual provider, active in the CMS NPPES registry since November 29, 2021.
## Identity
- **NPI:** 1215695077 (Entity type: Individual)
- **Enumerated:** November 29, 2021
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 347643 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 19 LAUREL AVE, Cornwall, NY 12518-1403
- **Phone:** (845) 534-7711
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Hudson Vista Medical,pc (NPI 1659666840, Cornwall, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** November 29, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1215695077) · Data from the CMS NPPES public registry.