Kimberly Ann Stack, AGPCNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

26NJ15212300 Issued in NJ

Practice address

277 NJ - 70
Toms River, NJ 08755

Phone

(212) 516-2300

NPI assigned

Feb 27, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Alignmed Medical Group NJ, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Fair Lawn, NJ
  • NPI 1245061605

  Single Specialty

  Medicare reassignment NPD
• Bastidas Plastic Surgery, PC

  • Plastic Surgery Physician
  • Paterson, NJ
  • NPI 1053724674

  Single Specialty

  Medicare reassignment NPD
• GPS Physician Group of New Jersey, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Voorhees, NJ
  • NPI 1548776008

  Single Specialty

  Medicare reassignment NPD
• Promed Preferred NJ P.C.

  • Internal Medicine Physician
  • Toms River, NJ
  • NPI 1578327722

  Single Specialty

  Medicare reassignment NPD
• Geps Physician Group of New Jersey PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Kennett Square, PA
  • NPI 1871512038

  NJ, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1316744287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 KINGSLAND AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070712734",
            "telephone_number": "201-394-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 NJ - 70",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "08755",
            "telephone_number": "212-516-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": "NJ",
            "license": "26NJ15212300",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ15212300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sprouting Minds
• Aishwarya Sridhar
• St Luke Medical Services Inc
• Kelly St. Marie, MSN, FNP-C
• Michelle Stacey, LSW
• Eric Philip Stander, M.D.
• Charles R. Stanfield, DC
• Jennifer Stanton, PT
• Starrising Telehealth Clinic PLLC
• Start Today Therapy LLC

• Gerontology Nurse Practitioner in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.