Individual provider Active NPI

Kristen Nicole Brosh, CRNP

  • Nurse Practitioner
  • Kulpmont, PA
National Provider Identifier
1053065136
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP025341 Issued in PA
Practice address
119 Nevada Dr
Kulpmont, PA 17834-1960
Phone
(570) 373-1250
Fax
(570) 373-1718
NPI assigned
Feb 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP025341 PA
Nurse Practitioner 363L00000X SP025341 PA Primary

Addresses

Primary practice location

119 Nevada Dr
Kulpmont, PA 17834-1960

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
SP025341OtherPASTATE BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knduceman@geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220401000558 PA Practitioner - Nurse Practitioner 0143616052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

119 Nevada Dr
Kulpmont, PA 17834-1960
Phone (570) 373-1250

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

  • Geisinger Home Health Home health agency, Danville, PA, CCN 397718
  • Vna Health System Home health agency, Shamokin, PA, CCN 397053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP025341PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Nurse Practitioner CurrentSince Apr 4, 2022 Accepting new patients
Geisinger Clinic Nurse Practitioner Current Accepting new patients
Geisinger Clinic CurrentSince Apr 4, 2022 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

701 W Oak St
Frackville, PA 17931
Phone (570) 874-4100

119 Nevada Dr
Kulpmont, PA 17834
Phone (570) 373-1250

10990 State Route 61
Mount Carmel, PA 17851
Phone (570) 339-4513

300 Hollywood Blvd
Orwigsburg, PA 17961
Phone (570) 366-1557

529 Terry Reiley Way
Pottsville, PA 17901
Phone (570) 624-4120

Interoperability endpoints

  • Direct secure messaging: kduceman492810@direct.geisinger.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1053065136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 NEVADA DR",
            "city": "KULPMONT",
            "state": "PA",
            "postal_code": "178341960",
            "telephone_number": "570-373-1250",
            "fax_number": "570-373-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSH",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP025341",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP025341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD",
            "identifier": "SP025341",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knduceman@geisinger.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "119 Nevada Dr",
            "city": "Kulpmont",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178341960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kulpmont, PA

Sources for this page

Verify at the official NPI Registry.