Individual provider Active NPI

Kimberly Ann Watson, ARNP-C

  • Family Nurse Practitioner
  • Miami Beach, FL
National Provider Identifier
1013235399
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350192 Issued in NY
Practice address
1669 Collins Ave
Miami Beach, FL 33139-3136
Phone
(305) 532-7909
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00289300 NJ
Family Nurse Practitioner 363LF0000X ARNP9417498 FL
Family Nurse Practitioner 363LF0000X 350192 NY Primary

Addresses

Primary practice location

1669 Collins Ave
Miami Beach, FL 33139-3136

Mailing address

1669 Collins Ave
Miami Beach, FL 33139-3136
Phone (305) 532-7909

Other names 1

  • Kimberly Ann Watson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220915003791 NY Practitioner - Nurse Practitioner 7416146667 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Beacon Health Medical PCGroup PAC ID 1658804760, 36 clinicians

Practice addresses (Care Compare)

17 W 9TH St
Brooklyn, NY 11231-2501
Phone (718) 599-9090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9417498FLMDFamily Nurse Practitioner
26NJ00289300NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Health Medical PC CurrentSince Jan 1, 2025 Accepting new patients
New York Medical Physician Associates PC CurrentSince May 8, 2024 Accepting new patients
New York Medical Physician Associates PC CurrentSince May 8, 2024 Accepting new patients
Dendrinos Medical Associates, P.a. Past Accepting new patients
Orlando Family Physicians, LLC PastSince Jan 5, 2025 Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

17 W 9th St
Brooklyn, NY 11231
Phone (718) 599-9090

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1013235399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 COLLINS AVE",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331393136",
            "telephone_number": "305-532-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 COLLINS AVE",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331393136",
            "telephone_number": "305-532-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00289300",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9417498",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WATSON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.