Individual provider Active NPI

Kira Oppenheim, ANP

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1083737555
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
303630 Issued in NY
Practice address
2327 83Rd St
Suite D
Brooklyn, NY 11214-2750
Phone
(718) 236-0700
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402927 NY
Adult Health Nurse Practitioner 363LA2200X 303630 NY Primary

Addresses

Primary practice location

2327 83Rd St
Suite D
Brooklyn, NY 11214-2750

Mailing address

1200 Gravesend Neck Rd
Apt.3L
Brooklyn, NY 11229-4256
Phone (917) 553-4040

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
I20190715002836 NY Practitioner - Nurse Practitioner 5890731905 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kings Medical Care, P.C.Group PAC ID 0749171908, 4 clinicians

Practice addresses (Care Compare)

7620 Bay Pkwy
Suite 1B
Brooklyn, NY 11214-1534
Phone (718) 232-1492

9517 Ave J
Brooklyn, NY 11236-3904
Phone (917) 553-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303630NYMDAdult Health Nurse Practitioner
402927NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ko Psychiatric NP PC Psychiatric/Mental Health CurrentSince Apr 1, 2022 Accepting new patients
Ko NP in Psychiatry PC Psychiatric/Mental Health CurrentSince Jul 10, 2022 Accepting new patients
Kings Medical Care, P.C. CurrentSince Aug 17, 2020 Accepting new patients
MJHS Medical Associates CurrentSince Jul 1, 2019 Accepting new patients
Advanced Neurology PC PastSince Aug 17, 2020 Accepting new patients
Navarre Sleep Disorder Group Inc Past Accepting new patients

Locations

7620 Bay Pkwy
Ste 1B
Brooklyn, NY 11214
Phone (718) 232-1492

9517 Avenue J
Brooklyn, NY 11236
Phone (718) 645-4324

55 Water St
Fl 46
New York, NY 10041
Phone (212) 440-1943

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1083737555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GRAVESEND NECK RD",
            "address_2": "APT.3L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294256",
            "telephone_number": "917-553-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 83RD ST",
            "address_2": "SUITE D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142750",
            "telephone_number": "718-236-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPENHEIM",
        "first_name": "KIRA",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402927",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.