Kimberly Mirakaj, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

790791 Issued in NY

Practice address

280 Broadway Suite 200
Newburgh, NY 12550-8272

Phone

(845) 564-7326

NPI assigned

Mar 22, 2022

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

• Ms. Kimberly Gibson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1205585700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BROADWAY SUITE 200",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125508272",
            "telephone_number": "845-562-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BROADWAY SUITE 200",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125508272",
            "telephone_number": "845-564-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRAKAJ",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2024-10-17",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "790791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GIBSON",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jamie Miller, OTA
• Tarah Miller, COTA/L
• Karen Mills, PT
• Laura Minard
• Stephanie A Mineo, MHC
• Cynthia Mitchell, LPN
• Ridwan Sohail Mitha, MD
• MM Islam MD PC
• Siddharth Pulin Modi, M.D.
• Kathleen M Moffit, N.P.

• Adult Psychiatric/Mental Health Registered Nurse in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Adult Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.