Individual provider Active NPI

Kristina Kininmonth, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1326719196
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115001 Issued in FL
Practice address
2919 W Swann Ave Ste 404
Tampa, FL 33609-4052
Phone
(813) 773-0579
Fax
(941) 253-3401
NPI assigned
Sep 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9115001 FL Primary

Addresses

Primary practice location

2919 W Swann Ave Ste 404
Tampa, FL 33609-4052

Mailing address

4027 Condor LN
Sarasota, FL 34232-4915
Phone (847) 542-9003

Other practice location 1

5460 63rd St E
Bradenton, FL 34203-7808
Phone (813) 773-0579

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
I20211012000028 FL Practitioner - Physician Assistant 8729486444 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9115001FLMDPhysician Assistant

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJIJCD/Endpoint/HJIJCD

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.

Hospital & facility affiliations 1

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": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1326719196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4027 CONDOR LN",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342324915",
            "telephone_number": "847-542-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 W SWANN AVE STE 404",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094052",
            "telephone_number": "813-773-0579",
            "fax_number": "941-253-3401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5460 63rd St E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342037808",
            "country_code": "US",
            "telephone_number": "813-773-0579",
            "fax_number": "941-253-3401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KININMONTH",
        "first_name": "KRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.