KATHLEEN MINCONE – Acute Care Nurse Practitioner, NPI 1104460245

KATHLEEN MINCONE is a healthcare provider. based in South huntington, New York. specializing in Acute Care Nurse Practitioner. They hold a License No. 431643 (NY). The NPI Number for KATHLEEN MINCONE is 1104460245

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN MINCONE
NPI
1104460245
Phone
(631) 903-3975
Address
12 SCHUBERT CT
Enumeration Date
1 November 2019
Last Update Date
1 November 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2126392000
Graduation Year
2019 (7 years ago)
PAC ID
1355777913
Group Practice PAC ID
4082503354
Professional Enrollment ID
I20200130002449
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

Provider Addresses for KATHLEEN MINCONE

  • 12 SCHUBERT CT

    SOUTH HUNTINGTON, NY 117464753

    Phone: (631) 903-3975

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-01-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200130002449INurse PractitionerNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 11746)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082503354View full group profile

Reviews

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Frequently asked questions

How is KATHLEEN MINCONE identified in CMS data?
CMS-hosted NPPES data lists KATHLEEN MINCONE with NPI 1104460245.
Can I rely on KATHLEEN MINCONE being an active provider?
As of the registry snapshot, KATHLEEN MINCONE is marked active.
What taxonomy line describes KATHLEEN MINCONE?
For research purposes, treat KATHLEEN MINCONE as Acute Care Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Does KATHLEEN MINCONE list a practice location?
Patients near South Huntington, New York may find KATHLEEN MINCONE in results; validate coverage separately.
Why does KATHLEEN MINCONE have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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