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ALAN MICHAEL KISNER M.D.
NPI 1790766673
Specialist in Huntington, NY

Active since November 08, 2005PECOS EnrolledCLIA 33D2104601 · Waiver
100 E MAIN ST, HUNTINGTON, NY 11743(631) 424-4004(631) 424-4027 Get Directions Write a Review

NPPES record last updated: June 18, 2008. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Alan Michael Kisner M.d. NPPES

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

ALAN MICHAEL KISNER M.D. (NPI 1790766673) is an individual specialist in Huntington, New York, licensed in New York (1216841) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through November 8, 2027, and is a graduate of Other (1967).

NPPES Registry Identity

NPI1790766673
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameALAN MICHAEL KISNERCredential: M.D.
Location Address100 E MAIN STHuntington, NY 11743-2816
Mailing Address100 E Main StHuntington, NY 11743-2816 · (631) 424-4004 · Fax (631) 424-4027
Phone(631) 424-4004
Fax(631) 424-4027
Sole ProprietorYes
Medical School CMSOtherGraduated 1967
Enumeration DateNovember 8, 2005
Last NPPES UpdateJune 18, 2008
✔ NPI 1790766673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 1216841
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
100 E MAIN ST, Huntington, NY 11743
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Other Identifiers 2

Medicare UPINB12856NY
Medicare PIN318351NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alan Michael Kisner M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID840286720
PECOS Enrollment IDI20040424000293
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2104601

Alan M Kisner Facs, Frcs Plastic Surgery, PLLC · Huntington, NY
Active · expires Nov 8, 2027
CLIA Number33D2104601
Laboratory TypePhysician Office
Certificate Effective DateNovember 9, 2025
Certificate Expiration DateNovember 8, 2027
Laboratory DirectorDr. Alan M. Kisner
Laboratory Phone(631) 424-4004
Laboratory LocationAlan M Kisner Facs, Frcs Plastic Surgery, PLLC100 East Main Street, Huntington, NY 11743
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims

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.

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
20 services20 patients

Other Providers at the Same Location NPPES 5

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

ALAN M KISNER PLASTIC SURGERY PLLC
Specialist
100 E MAIN ST
HUNTINGTON, NY 11743
Suffolk County (631) 424-4004
LINDA GOTTLIEB FNP
Nurse Practitioner (Family)
100 E MAIN ST
HUNTINGTON, NY 11743
Suffolk County (631) 424-4004
MEREDITH VANDEGRIFT, MD, PC
Plastic Surgery
100 E MAIN ST
HUNTINGTON, NY 11743
Suffolk County (631) 935-0303
DR. MEREDITH T VANDEGRIFT MD
Plastic Surgery
100 E MAIN ST
HUNTINGTON, NY 11743
Suffolk County (631) 935-0303
KSC OR SERVICES, INC.
Clinic/Center (Ambulatory Surgical)
100 E MAIN ST, SUITE B
HUNTINGTON, NY 11743
Suffolk County (631) 424-4004

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 Alan Kisner's NPI number?

The NPI number for Alan Kisner is 1790766673. It was assigned to this individual provider in the NPPES registry on November 8, 2005.

Where is Alan Kisner located?

Alan Kisner practices at 100 E Main St, Huntington, NY 11743. The listed phone number is (631) 424-4004.

What is Alan Kisner's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Alan Kisner enrolled in Medicare?

Yes. Alan Kisner is registered in the Medicare PECOS enrollment system.

Does Alan Kisner hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2104601) is associated with this NPI, valid through November 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Alan Kisner was last updated on June 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.