Individual provider Active NPI

Kylie B Carimi, APRN, FNP-C

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1174276737
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1150858 Issued in TX
Practice address
700 Olympic Plaza Cir Ste 850
Tyler, TX 75701-1955
Phone
(903) 595-2441
Fax
(903) 595-0743
NPI assigned
Feb 2, 2022
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1150858 TX Primary
Registered Nurse 163W00000X 967479 TX

Addresses

Primary practice location

700 Olympic Plaza Cir Ste 850
Tyler, TX 75701-1955

Mailing address

700 Olympic Plaza Cir Ste 850
Tyler, TX 75701-1955
Phone (903) 595-2441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241120002186 TX Practitioner - Nurse Practitioner 3577098045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tyler Neurosurgical Associates, P.a.Group PAC ID 7810929833, 8 clinicians

Practice addresses (Care Compare)

700 Olympic Plaza Cir
Suite 850
Tyler, TX 75701-1955
Phone (903) 595-2441

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
967479TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Neurosurgical Associates, P.a. CurrentSince Nov 11, 2024 Accepting new patients

Locations

700 Olympic Plaza Cir
Ste 850
Tyler, TX 75701
Phone (903) 595-2441

Interoperability endpoints

  • Direct secure messaging: kcarimi350167@ahs.direct-ci.com
  • Direct secure messaging: kylie.carimi.1@31741.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1174276737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 850",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011955",
            "telephone_number": "903-595-2441",
            "fax_number": "903-595-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 850",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011955",
            "telephone_number": "903-595-2441",
            "fax_number": "903-595-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARIMI",
        "first_name": "KYLIE",
        "middle_name": "B",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-02",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1150858",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "967479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.