Individual provider Active NPI

Kyle Possemato, NP

  • Family Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1316462385
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95007008 Issued in CA
Practice address
2410 California St
San Francisco, CA 94115-2681
Phone
(415) 529-4050
Fax
(415) 291-0489
NPI assigned
Aug 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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 95007008 CA Primary

Addresses

Primary practice location

2410 California St
San Francisco, CA 94115-2681

Mailing address

2410 California St
San Francisco, CA 94115-2681
Phone (415) 529-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20230111000203 CO Practitioner - Nurse Practitioner 7517379845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

1400 Jackson St
BLDG T
Denver, CO 80206-2761
Phone (303) 812-3800

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

  • Saint Joseph Hospital Hospital, Denver, CO, CCN 060028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95007008CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 16, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 16, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC PastSince Oct 17, 2021 Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1400 Jackson St
Ste 550
Denver, CO 80206
Phone (303) 318-3800

1400 Jackson St
Bldg T
Denver, CO 80206
Phone (303) 812-3800

Organizations & group practices 4

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.

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": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1316462385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 CALIFORNIA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152681",
            "telephone_number": "415-529-4050",
            "fax_number": "415-291-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 CALIFORNIA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152681",
            "telephone_number": "415-529-4050",
            "fax_number": "415-291-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POSSEMATO",
        "first_name": "KYLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-10",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.