Individual provider Active NPI

Khatuna Kipiani, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1104151554
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F352869 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(718) 583-7736
Fax
(718) 537-6180
NPI assigned
Oct 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F352869 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

2626 Halperin Ave
Bronx, NY 10461-2631
Phone (718) 618-0401

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
I20240426001565 NY Practitioner - Nurse Practitioner 4183064983 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
House Call Medical Services of New York, PLLCGroup PAC ID 2264517754, 162 clinicians

Practice addresses (Care Compare)

1371 Seabury Ave
Bronx, NY 10461-3651
Phone (718) 618-0401

Hospital & facility affiliations

  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F352869NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
House Call Medical Services of New York, PLLC Internal Medicine CurrentSince Feb 14, 2024 Accepting new patients
Essen Medical Associates, PC CurrentSince Feb 14, 2024 Accepting new patients
Bronx Medical Practice P.C. Internal Medicine CurrentSince Feb 14, 2024 Accepting new patients
Essen Medical Associates, PC CurrentSince Feb 14, 2024 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Feb 14, 2024 Accepting new patients

Locations

3130 Grand Concourse
Ste 1N
Bronx, NY 10458
Phone (718) 365-0892

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2722 White Plains Rd
Ste A
Bronx, NY 10467

2308 Eastchester Rd
Bronx, NY 10469

502 E Tremont Ave
Bronx, NY 10457
Phone (646) 762-6905

616 Castle Hill Ave
Ste A
Bronx, NY 10473

3134 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1000

5667 Riverdale Ave
Bronx, NY 10471

1009 E 163rd St
Bronx, NY 10459
Phone (718) 828-6800

2742 3rd Ave
Ste A
Bronx, NY 10455

1181 Grand Concourse
Bronx, NY 10452
Phone (718) 655-1400

1990 McGraw Ave
Ste A
Bronx, NY 10462

1434 Williamsbridge Rd
Bronx, NY 10461
Phone (718) 597-1434

2445 Arthur Ave
Bronx, NY 10458
Phone (718) 220-3434

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 5

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 1

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": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1104151554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 HALPERIN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612631",
            "telephone_number": "718-618-0401",
            "fax_number": "347-479-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-583-7736",
            "fax_number": "718-537-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPIANI",
        "first_name": "KHATUNA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F352869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.