Kimberly Marie Kafouse, FNP

Key facts

NPI

1316613797

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

RN2277358 (MA)

Practice address

29 Deer Path LN
Weston, MA 02493-1139

Phone

(781) 642-1912

NPI assigned

Aug 17, 2021

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Ajay Anand MD PC Internal Medicine Physician · Weston, MA · NPI 1558403154
  Medicare reassignment NPD MA
• Circle Medical Team LLC Internal Medicine Physician · Walpole, MA · NPI 1942832027
  Medicare reassignment NPD MA
• Ajay Anand MD PC Nursing Facility/Intermediate Care Facility · Weston, MA · NPI 1376093260
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 11, 2022.

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1316613797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 DEER PATH LN",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931139",
            "telephone_number": "781-642-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 DEER PATH LN",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931139",
            "telephone_number": "781-642-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAFOUSE",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2277358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Weston, MA · Family Nurse Practitioner in Massachusetts