Kimberly C Nicastro, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002502 Issued in VA

Practice address

15195 Heathcote Blvd Ste 150
Haymarket, VA 20169-6243

Phone

(571) 636-6000

Fax

(571) 636-6010

NPI assigned

Feb 2, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Naeger Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: knicastro426597@direct.healthsystem.virginia.edu

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Jackson Surgical Assistants, LLC

  • Surgery Physician
  • Alpharetta, GA
  • NPI 1487934550

  Surgical

  NPD (past)

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1164660940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15195 HEATHCOTE BLVD STE 150",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201696243",
            "telephone_number": "571-636-6000",
            "fax_number": "571-636-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICASTRO",
        "first_name": "KIMBERLY",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knicastro426597@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15195 Heathcote Blvd Ste 150",
            "city": "Haymarket",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201696243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "NAEGER",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vivian Nangoyi Nakawala, NP
• Meae Nam
• Christi Nelson
• New Path Counseling Center LLC
• CHI M Nguyen
• NMG Affiliate Practice I, LLC
• NMG Affiliate Practice I, LLC
• NMG Affiliate Practice I, LLC
• NMG Affiliate Practice I, LLC
• Eric C. Noh, DO

• All providers in Haymarket, VA
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.