Kristen Dismore, PA in Port Jefferson, NY - Medicare Surgery

Kristen Dismore, PA is a medicare enrolled "Surgery" physician in Port Jefferson, New York. Her current practice location is 625 Belle Terre Rd Ste 202, Port Jefferson, New York. You can reach out to her office (for appointments etc.) via phone at (631) 686-7990.

Kristen Dismore is licensed to practice in New York (license number 025086) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1326654120.

Contact Information

	Kristen Dismore, PA
	625 Belle Terre Rd Ste 202, Port Jefferson, NY 11777-2318
	(631) 686-7990
	Not Available

Physician's Profile

Full Name	Kristen Dismore
Gender	Female
Speciality	Surgery
Location	625 Belle Terre Rd Ste 202, Port Jefferson, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1326654120
Provider Enumeration Date: 09/17/2020
Last Update Date: 09/17/2020

Medicare PECOS Information:

PECOS PAC ID: 5496140535
Enrollment ID: I20220328001125

Medical Identifiers

Medical identifiers for Kristen Dismore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1326654120	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	025086 (New York)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kristen Dismore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kristen Dismore, PA 4 Hazelwood Ave Apt 1, Westhampton Beach, NY 11978-1405 Ph: (631) 445-1147	Kristen Dismore, PA 625 Belle Terre Rd Ste 202, Port Jefferson, NY 11777-2318 Ph: (631) 686-7990

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Surgery Doctors in Port Jefferson, NY

Frank P Lunati Jr., MD Surgery Medicare: May Accept Medicare Assignments Practice Location: 70 N Country Rd, Ste 201, Port Jefferson, NY 11777 Phone: 631-403-4310 Fax: 631-403-4312
Markella Michael Christakis, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 70 N Country Rd, Suite 201, Port Jefferson, NY 11777 Phone: 631-403-4310 Fax: 631-403-4312
Ann Marie Defnet, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 70 N Country Rd Ste 102, Port Jefferson, NY 11777 Phone: 631-938-6999
Tina Joseph, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 625 Belle Terre Rd, Suite 202, Port Jefferson, NY 11777 Phone: 631-689-0220 Fax: 631-686-7626
Edward B Borden, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 625 Belle Terre Rd Ste 201, Port Jefferson, NY 11777 Phone: 631-474-0707 Fax: 631-474-4034
Dr. William Joseph Sellers, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 70 N Country Rd Ste 203, Port Jefferson, NY 11777 Phone: 631-474-0707

Kristen Dismore, PA - Medicare Surgery in Port Jefferson, NY