Individual provider Active NPI

Kristen Molly Fibbio, APRN

  • Family Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1316609340
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11013269 Issued in FL
Practice address
801 N Flamingo Rd
Pembroke Pines, FL 33028-1019
Phone
(954) 265-4325
NPI assigned
Oct 7, 2021
Last updated
Oct 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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 11013269 FL Primary

Addresses

Primary practice location

801 N Flamingo Rd
Pembroke Pines, FL 33028-1019

Mailing address

11700 SW 2ND St Apt 206
Pembroke Pines, FL 33025-3499
Phone (954) 235-6813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220307001804 FL Practitioner - Nurse Practitioner 6901290089 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
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1150 N 35 Ave
Hollywood, FL 33021-5424

12235 Pines Blvd
Pembroke Pines, FL 33026-4119
Phone (954) 265-4325

1750 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4611
Phone (954) 265-4325

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11013269FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Nov 27, 2021 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District CurrentSince Nov 27, 2021 Accepting new patients

Locations

20950 NE 27th Ct
Ste 203
Aventura, FL 33180
Phone (305) 933-6545

1150 N 35th Ave
Ste 170
Hollywood, FL 33021
Phone (954) 985-1500

801 N Flamingo Rd
Pembroke Pines, FL 33028
Phone (954) 844-6868

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1316609340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 SW 2ND ST APT 206",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330253499",
            "telephone_number": "954-235-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281019",
            "telephone_number": "954-265-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIBBIO",
        "first_name": "KRISTEN",
        "middle_name": "MOLLY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11013269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.