Kaitlyn Nicole Dervenis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71015363A Issued in IN

Practice address

493 Westfield Rd
Noblesville, IN 46060-1303

Phone

(317) 848-0361

NPI assigned

Jan 23, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverview HospitalGroup PAC ID 1153216627, 209 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverview Health Hospital, Noblesville, IN, CCN 150059

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Riverview Hospital

  • Family Medicine Physician
  • Noblesville, IN
  • NPI 1609074921
  Medicare reassignment Care Compare group NPD
• Riverview Hospital

  • Skilled Nursing Facility
  • Indianapolis, IN
  • NPI 1831164995
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Riverview Hospital

  • General Acute Care Hospital
  • Noblesville, IN
  • NPI 1700883717
  Care Compare affiliation

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1023879376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5889 SANDALWOOD DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460338216",
            "telephone_number": "317-363-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 WESTFIELD RD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460601303",
            "telephone_number": "317-848-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERVENIS",
        "first_name": "KAITLYN",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015363A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Madison Marie Devault, NP
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• Family Nurse Practitioner in Noblesville, IN
• Providers in Noblesville, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.