Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Muzzonigro, PA

Individual provider Physician Assistant · NPI 1386001725

Kimberly Muzzonigro, PA is a Physician Assistant in Manorville, New York. Qualified in 2015, 11 years ago. Practices with Peconic Bay Primary Medical Care, a 72-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
11
Licensed in
NY
In the registry since
2016
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

496 County Road 111 Bldg B
Manorville, NY 11949-3383
Phone: (631) 405-3200
Fax: (631) 395-6010
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 019345 (NY)

Record details

NPI number1386001725
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 15, 2016
Last updated in NPPESApril 19, 2024
Certification dateApril 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Peconic Bay Primary Medical Care — 72 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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