Individual provider Active NPI

Kimberly Snyder Ristau, ARNP

  • Adult Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1023274727
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1756262 Issued in FL
Practice address
2333 W Hillsborough Ave Ste 100
Tampa, FL 33603-1059
Phone
(813) 872-4492
NPI assigned
Aug 1, 2008
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1756262 FL Primary

Addresses

Primary practice location

2333 W Hillsborough Ave Ste 100
Tampa, FL 33603-1059

Mailing address

5108 Bay Isle Cir
Clearwater, FL 33760-2959
Phone (727) 422-0856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090209000202 FL Practitioner - Nurse Practitioner 4082779038 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Pain Relief Center IncGroup PAC ID 6002715158, 33 clinicians

Practice addresses (Care Compare)

2333 W Hillsborough Ave
Suite 100
Tampa, FL 33603-1059
Phone (813) 872-4492

Merit-based Incentive Payment System (MIPS)

Final score
84.72 of 100Reported as group
Promoting interoperability
78
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1756262FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pain Relief Group PLLC CurrentSince Oct 10, 2018 Accepting new patients
Charles K Friedman DO PA CurrentSince Oct 10, 2018 Accepting new patients

Locations

1320 S Belcher Rd
Clearwater, FL 33764
Phone (727) 518-8660

5767 49th St N
St Petersburg, FL 33709
Phone (727) 350-0450

5767 49th St N
Ste A
St Petersburg, FL 33709
Phone (727) 350-0450

3450 E Fletcher Ave
Ste 350
Tampa, FL 33613
Phone (813) 739-7493

4730 N Habana Ave
Ste 104
Tampa, FL 33614
Phone (813) 426-8260

7518 Cypress Gardens Blvd
Winter Haven, FL 33884
Phone (813) 426-8263

Interoperability endpoints

  • Direct secure messaging: kim.jones@painreliefcenter.directbygreenway.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1023274727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 BAY ISLE CIR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337602959",
            "telephone_number": "727-422-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 W HILLSBOROUGH AVE STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336031059",
            "telephone_number": "813-872-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISTAU",
        "first_name": "KIMBERLY",
        "middle_name": "SNYDER",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "1756262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.