MS. KERRI ANN PETITPAIN
NPI 1760621304
Nurse Practitioner - Family in Manorville, NY
About Ms. Kerri Ann Petitpain NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. KERRI ANN PETITPAIN (NPI 1760621304) is an individual family provider in Manorville, New York, licensed in New York (333951) and active in the NPI registry since February 2009. She is enrolled in Medicare PECOS and is a graduate of State University Of New York At Stony Brook, School Of Medicine (2002).
NPPES Registry Identity
Specialties & Licenses
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
Ms. Kerri Ann Petitpain 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 Kerri Petitpain reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Manorville, NY 11949
- Reassigned Medicare billing, New York enrollment
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 6
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11949 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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's NPI number?
The NPI number for Kerri Petitpain is 1760621304. It was assigned to this individual provider in the NPPES registry on February 4, 2009.
Where is Kerri Petitpain located?
Kerri Petitpain practices at 18 Scott Ln, Manorville, NY 11949. The listed phone number is (631) 905-6890.
What is Kerri Petitpain's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kerri Petitpain enrolled in Medicare?
Yes. Kerri Petitpain 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 Kerri Petitpain's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kerri Petitpain reassigns Medicare benefits to Kerri Petitpain Medical (Manorville, 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 Kerri Petitpain'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 Kerri Petitpain 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.
# Ms. Kerri Ann Petitpain · NPI 1760621304
Family physician in Manorville, New York. Individual provider, active in the CMS NPPES registry since February 4, 2009.
## Identity
- **NPI:** 1760621304 (Entity type: Individual)
- **Enumerated:** February 4, 2009
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 333951 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 18 SCOTT LN, Manorville, NY 11949-2624
- **Phone:** (631) 905-6890 · **Fax:** (888) 920-2296
## 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:** Kerri Petitpain Medical (NPI 1184253262, Manorville, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** State University Of New York At Stony Brook, School Of Medicine, class of 2002
## Record status
- **NPPES last updated:** April 2, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1760621304) · Data from the CMS NPPES public registry.