Kenneth William Nissen
ANP | Nurse Practitioner - Adult Health | 13+ years Exp
75 N Country Rd, Port Jefferson
New York, 11777-2119
631-476-2786
Kenneth William Nissen is a Port Jefferson, New York based nurse practitioner with 13 years of experience in Adult Health. He completed his graduation from State University Of New York At Stony Brook, School Of Medicine in 2012. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Kenneth William Nissen is 306258 for Adult Health in New York. His current practice location is 75 N Country Rd, Port Jefferson. Patients can reach him at 631-476-2786. Kenneth William Nissen is ANP with specialization in Adult Health and his NPI number (Unique professional ID assigned by NPPES) is 1043659980.
Kenneth William Nissen can evaluate, diagnose patients overall wellness, and conditions such as cancer, heart disease, diabetes, arthritis, sports injuries, and other ailments. He can see patients and promote healthy living and wellness. He can perform physical examinations, order and interpret tests, prescribe medications and treatments, and can also provide education and counseling to patients on wellness strategies and disease prevention.
Complete Profile:
Kenneth William Nissen speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Kenneth William Nissen |
| Specialization: | Adult Health Nurse Practitioner (ANP) |
| Gender: | Male |
| Credentials: | ANP |
| Experience: | 13+ years |
| Medical School Attended: | State University Of New York At Stony Brook, School Of Medicine |
| Graduation Year: | 2012 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 75 N Country Rd, Port Jefferson,
New York, 11777-2119 |
| Phone: | 631-476-2786 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 2264667633 |
| Enrollment ID: | I20131022000044 |
| NPI Number: | 1043659980 |
| NPI Enumeration Date: | 24 Jun, 2013 |
| NPI Last Update On: | 24 Jun, 2013 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kenneth William Nissen are as mentioned below.
| License Number | Specialization | State | Status | |
| 306258 | Adult Health | New York | Primary | |
Hospital Affiliation:
NPs can be affiliated to many hospitals whom they worked with in the past or are presently working with. One NP can be affiliated to four to five hospitals at a time.
| Hospital Name (CCN) | State | Hospital Type |
| (330185) | Port jefferson, NY | Acute Care Hospital |
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Kenneth William Nissen is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| North Shore-lij Cardiovascular Medicine Pc (7012194806) | 138 |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Kenneth William Nissen
25 Wiltshire Dr,
Commack, New York |
| Zip: | 11725-3330 |
| Phone Number: | 516-521-0456 |
Patients can reach Kenneth William Nissen at
75 N Country Rd, Port Jefferson, New York or can
call to book an appointment on 631-476-2786.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.