KELLY ANN ANTIMISIARIS
NPI 1265213797
Nurse Practitioner - Psychiatric/Mental Health in Massapequa, NY

Q: What is Kelly Antimisiaris's NPI number?

The NPI number for Kelly Antimisiaris is 1265213797. It was assigned to this individual provider in the NPPES registry on October 10, 2023.

Q: What is Kelly Antimisiaris's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since October 10, 2023PECOS EnrolledAccepts Medicare Assignment

5550 MERRICK RD, MASSAPEQUA, NY 11758(631) 773-1096 Get Directions Write a Review

NPPES record last updated: October 10, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kelly Ann Antimisiaris NPPES

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

KELLY ANN ANTIMISIARIS (NPI 1265213797) is an individual psychiatric/mental health provider in Massapequa, New York, licensed in New York (405343) and active in the NPI registry since October 2023. She is enrolled in Medicare PECOS, is affiliated with Ns/lij Hs Southside Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1265213797

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameKELLY ANN ANTIMISIARIS

Location Address5550 MERRICK RDMassapequa, NY 11758-6238

Mailing Address5550 Merrick RdMassapequa, NY 11758-6238

Phone(631) 773-1096

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateOctober 10, 2023

NPPES CertifiedOctober 10, 2023

✔ NPI 1265213797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in NY · 405343

5550 MERRICK RD, Massapequa, NY 11758

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

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

Kelly Ann Antimisiaris 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 ID9234577339

PECOS Enrollment IDI20240409002840

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.

Hospital Affiliations CMS Care Compare

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

Ns/Lij Hs Southside Hospital

Acute Care Hospitals · Bay Shore, NY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330043

Location301 East Main StreetBay Shore, NY 11706 · Suffolk County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11758 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 13

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

MARGARET WELLS MT-BC

Counselor (Mental Health)