Kevin Nissen, PH.D.
NPI 1245093616 · Psychologist · Northport, NY
Enrolled with Medicare as Practitioner - Clinical Psychologist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kevin Nissen, PH.D. is a Psychologist provider in Northport, NY (NPI 1245093616).
Provider details
- NPI number
- 1245093616
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-01-30
- Last updated
- 2024-01-30
- Certified
- 2024-01-30
Frequently asked questions
- What is Kevin Nissen's NPI number?
- Kevin Nissen's National Provider Identifier (NPI) is 1245093616, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kevin Nissen's specialty?
- Kevin Nissen is listed in the NPPES registry with a primary specialty of Psychologist (Behavioral Health & Social Service Providers).
- Where is Kevin Nissen located?
- Kevin Nissen's practice location on file with NPPES is 79 Middleville Rd, Northport, NY 11768-2200.
- What is Kevin Nissen's phone number?
- The practice phone number listed in the NPPES registry for Kevin Nissen is (631) 261-4400.
- Does Kevin Nissen accept Medicare?
- Kevin Nissen is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kevin Nissen's NPI active?
- Yes — Kevin Nissen's NPI (1245093616) is active in the NPPES registry as of the last update on 2024-01-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.