Kathleen Louise Kaminski, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN186248 Issued in MA

Practice address

575 Turnpike St Ste 25
North Andover, MA 01845-5937

Phone

(978) 290-4646

Fax

(978) 290-4822

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

Yes

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 MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1124589577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 TURNPIKE ST STE 25",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455937",
            "telephone_number": "978-290-4646",
            "fax_number": "978-290-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 TURNPIKE ST STE 25",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455937",
            "telephone_number": "978-290-4646",
            "fax_number": "978-290-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINSKI",
        "first_name": "KATHLEEN",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN186248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in North Andover, MA
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.