Individual provider Active NPI

Kimberlee M Bunkartas, APRN

  • Family Nurse Practitioner
  • Derry, NH
National Provider Identifier
1093944738
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
084105-23 Issued in NH
Practice address
6 Tsienneto Rd
Suite 300
Derry, NH 03038
Phone
(603) 216-0400
Fax
(603) 216-3800
NPI assigned
Jul 2, 2009
Last updated
Jun 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN255782 MA
Family Nurse Practitioner 363LF0000X RN255782 MA
Family Nurse Practitioner 363LF0000X 084105-23 NH Primary

Addresses

Primary practice location

6 Tsienneto Rd
Suite 300
Derry, NH 03038

Mailing address

PO Box 38
Derry, NH 03038
Phone (603) 216-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091109000264 MA Practitioner - Nurse Practitioner 7416095690 Reassigns benefits to 2 organizations
I20210111000790 NH Practitioner - Nurse Practitioner 7416095690 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN255782MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc CurrentSince Jun 1, 2010 Accepting new patients
Southern New Hampshire Internal Medicine Associates, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Lahey Clinic, Inc. CurrentSince Jun 1, 2010 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

160 S River Rd
Ste 101A
Bedford, NH 03110
Phone (603) 216-3800

6 Tsienneto Rd
Ste 300
Derry, NH 03038
Phone (603) 216-0479

49 Range Rd
Ste 110
Windham, NH 03087

Interoperability endpoints

  • Direct secure messaging: kbunkartas11020@direct.bilh.masshiway.net

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1093944738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "03038",
            "telephone_number": "603-216-0400",
            "fax_number": "603-216-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD",
            "address_2": "SUITE 300",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "03038",
            "telephone_number": "603-216-0400",
            "fax_number": "603-216-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNKARTAS",
        "first_name": "KIMBERLEE",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN255782",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN255782",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "084105-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.