JACLYN KISCHKOWER NP
NPI 1306677620
Nurse Practitioner in East Setauket, NY

Q: What is Jaclyn Kischkower's NPI number?

The NPI number for Jaclyn Kischkower is 1306677620. It was assigned to this individual provider in the NPPES registry on August 8, 2024.

Q: What is Jaclyn Kischkower's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Jaclyn Kischkower was last updated on August 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since August 08, 2024PECOS Enrolled

45 RESEARCH WAY STE 108, EAST SETAUKET, NY 11733(631) 941-2000(631) 941-2010 Get Directions Write a Review

NPPES record last updated: August 15, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 15, 2024, Aug 8, 2024 (2 updates tracked since 2024).

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About Jaclyn Kischkower Np NPPES

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

JACLYN KISCHKOWER NP (NPI 1306677620) is an individual nurse practitioner in East Setauket, New York, licensed in New York (311866) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306677620

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJACLYN KISCHKOWERCredential: NP

Location Address45 RESEARCH WAY STE 108East Setauket, NY 11733-6401

Mailing Address45 Research Way Ste 108East Setauket, NY 11733-6401 · (631) 941-2000 · Fax (631) 941-2010

Phone(631) 941-2000

Fax(631) 941-2010

Sole ProprietorYes

Enumeration DateAugust 8, 2024

Last NPPES UpdateAugust 15, 20242 updates tracked since enumeration

NPPES CertifiedAugust 15, 2024

✔ NPI 1306677620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NY · 311866

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

45 RESEARCH WAY STE 108, East Setauket, NY 11733

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaclyn Kischkower 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.

Medicare Billing Reassignment

Medicare enrollment records show Jaclyn Kischkower reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Stony Brook Internists, University Faculty Practice Corporation

1.9 mi

Pulmonary Disease

SUNY @ STONY BROOK, HSC, L16, RM 020
Stony Brook, NY 11794

Reassigned Medicare billing, New York enrollment
177 clinicians in this Medicare group

NPI 1104865229 (631) 444-2448

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11733 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.

KATHLEEN T CALLAGHAN NP, RN

Nurse Practitioner (Adult Health)

45 RESEARCH WAY STE 108
EAST SETAUKET, NY 11733

Suffolk County (631) 941-2000

NIRUPA RAMJISINGH PA

Physician Assistant (Medical)

45 RESEARCH WAY STE 108
EAST SETAUKET, NY 11733

Suffolk County (631) 941-2000

LINA CHEVALIER MD

Internal Medicine (Cardiovascular Disease)

45 RESEARCH WAY STE 108
EAST SETAUKET, NY 11733

Suffolk County (631) 941-2000

MS. JESSICA SOLTAN FNP-C

Nurse Practitioner (Family)

45 RESEARCH WAY STE 108
EAST SETAUKET, NY 11733

Suffolk County (631) 941-2000

MR. THOMAS JOSEPH PETTEI M.D.

Internal Medicine (Cardiovascular Disease)

45 RESEARCH WAY STE 108, STONY BROOK INTERNISTS
EAST SETAUKET, NY 11733

Suffolk County (631) 941-2000

NAOMI YSIMURA

Nurse Practitioner (Family)

45 RESEARCH WAY STE 108
EAST SETAUKET, NY 11733

Suffolk County (631) 941-2000

LEONIDAS MIRAS

Internal Medicine (Cardiovascular Disease)

45 RESEARCH WAY STE 108
EAST SETAUKET, NY 11733

Suffolk County (631) 941-2000

DEBORAH ANNE ROTH NP

Nurse Practitioner

45 RESEARCH WAY STE 108
EAST SETAUKET, NY 11733

Suffolk County (631) 941-2000

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 Jaclyn Kischkower's NPI number?

The NPI number for Jaclyn Kischkower is 1306677620. It was assigned to this individual provider in the NPPES registry on August 8, 2024.

Where is Jaclyn Kischkower located?

Jaclyn Kischkower practices at 45 Research Way Ste 108, East Setauket, NY 11733. The listed phone number is (631) 941-2000.

What is Jaclyn Kischkower's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jaclyn Kischkower enrolled in Medicare?

Yes. Jaclyn Kischkower is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jaclyn Kischkower's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Kischkower reassigns Medicare benefits to Stony Brook Internists, University Faculty Practice Corporation (Stony Brook, 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 Jaclyn Kischkower's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jaclyn Kischkower was last updated on August 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.