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STEPHANIE DOUGHTY KILGANNON
NPI 1669139085
Counselor - Mental Health in Massapequa, NY

Active since November 19, 2021PECOS Enrolled
54 CHERRY ST, MASSAPEQUA, NY 11758(718) 791-7487 Get Directions Write a Review

NPPES record last updated: November 19, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Stephanie Doughty Kilgannon NPPES

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

STEPHANIE DOUGHTY KILGANNON (NPI 1669139085) is an individual mental health provider in Massapequa, New York and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1669139085
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSTEPHANIE DOUGHTY KILGANNON
Location Address54 CHERRY STMassapequa, NY 11758-5117
Mailing Address54 Cherry StMassapequa, NY 11758-5117 · (718) 791-7487
Phone(718) 791-7487
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 19, 2021
NPPES CertifiedNovember 19, 2021
✔ NPI 1669139085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · SchoolTaxonomy 101YS0200X
54 CHERRY ST, Massapequa, NY 11758
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Other Names 1

Former Name (1)Stephanie Doughty

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of NC, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stephanie Doughty Kilgannon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6406314681
PECOS Enrollment IDI20260818003281
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 Reassignments

2

Medicare enrollment records show Stephanie Kilgannon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Brave Medical P.C.
28 mi
Community/Behavioral Health
73 MARKET ST FL 3
Yonkers, NY 10710
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Brave Medical PC
  • 54 clinicians in this Medicare group
NPI 1902415318 (305) 902-6347
Brave Health Medical Group PA
1,096 mi
Community/Behavioral Health
1951 NW 7TH AVE FL 3
Miami, FL 33136
  • Reassigned Medicare billing, Texas enrollment
  • 128 clinicians in this Medicare group
NPI 1225669161 (305) 902-6347

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 Stephanie Kilgannon's NPI number?

The NPI number for Stephanie Kilgannon is 1669139085. It was assigned to this individual provider in the NPPES registry on November 19, 2021. The provider is also known as Stephanie Doughty.

Where is Stephanie Kilgannon located?

Stephanie Kilgannon practices at 54 Cherry St, Massapequa, NY 11758. The listed phone number is (718) 791-7487.

What is Stephanie Kilgannon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Stephanie Kilgannon enrolled in Medicare?

Yes. Stephanie Kilgannon is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Stephanie Kilgannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stephanie Kilgannon reassigns Medicare benefits to 2 organizations: Brave Medical P.C. (Yonkers, NY) and Brave Health Medical Group PA (Miami, FL). Each 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 Stephanie Kilgannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Stephanie Kilgannon accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of NC and Blue Cross and Blue Shield of Texas list Stephanie Kilgannon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stephanie Kilgannon was last updated on November 19, 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.