Individual provider Active NPI

Kristen Rau, FNP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1154077618
Registry record updated Jul 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
265811 Issued in AZ
Practice address
350 W McLellan Rd Unit 4
Mesa, AZ 85201-2262
Phone
(480) 282-7187
NPI assigned
Feb 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 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 265811 AZ Primary

Addresses

Primary practice location

350 W McLellan Rd Unit 4
Mesa, AZ 85201-2262

Mailing address

1451 George Washington Memorial Hwy Unit 554
Gloucester Point, VA 23062-2747
Phone (480) 282-7187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MI, SC, FL4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20230926001350 VA Practitioner - Nurse Practitioner 4880048834 Reassigns benefits to 1 organization
I20231115003398 MI Practitioner - Nurse Practitioner 4880048834 Reassigns benefits to 1 organization
I20240405000303 SC Practitioner - Nurse Practitioner 4880048834 Reassigns benefits to 1 organization
I20240520000939 FL Practitioner - Nurse Practitioner 4880048834 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
Group practices
Michumi PLLCGroup PAC ID 5193784395, 40 clinicians

Practice addresses (Care Compare)

12997 Warwick Blvd
Newport News, VA 23602-8352
Phone (757) 369-9446

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28515SCMDHematology & Oncology Physician
265811AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michumi PLLC CurrentSince Jan 1, 2025 Accepting new patients
Peninsula Radiological Associates Limited Past Accepting new patients

Locations

12997 Warwick Blvd
Newport News, VA 23602
Phone (757) 369-3357

120 Monticello Ave
Williamsburg, VA 23185
Phone (757) 564-3627

Interoperability endpoints

  • Direct secure messaging: krau258472@direct.rivhs.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690070400000",
    "number": "1154077618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 GEORGE WASHINGTON MEMORIAL HWY UNIT 554",
            "city": "GLOUCESTER POINT",
            "state": "VA",
            "postal_code": "230622747",
            "telephone_number": "480-282-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W MCLELLAN RD UNIT 4",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852012262",
            "telephone_number": "480-282-7187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAU",
        "first_name": "KRISTEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2023-07-23",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "265811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.