Individual provider Active NPI

Kimberly Iniguez

  • Family Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1336979590
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030981 Issued in CA
Practice address
240 Shotwell St
San Francisco, CA 94110-1323
Phone
(415) 522-3870
NPI assigned
Aug 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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 95030981 CA Primary

Addresses

Primary practice location

240 Shotwell St
San Francisco, CA 94110-1323

Mailing address

3529 Branson Dr
San Mateo, CA 94403-2901
Phone (650) 678-5479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240912002836 CA Practitioner - Nurse Practitioner 6103366430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Area Health AssociatesGroup PAC ID 1153302419, 21 clinicians

Practice addresses (Care Compare)

240 Shotwell St
San Francisco, CA 94110-1323
Phone 41558268172548

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95030981CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Area Health Associates Current Accepting new patients

Locations

240 Shotwell St
San Francisco, CA 94110
Phone (415) 552-1013

1580 Valencia St
Ste 506
San Francisco, CA 94110
Phone (415) 641-6500

Interoperability endpoints

  • Direct secure messaging: kiniguez654043@direct.ochin.org

Organizations & group practices 1

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": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1336979590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3529 BRANSON DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944032901",
            "telephone_number": "650-678-5479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 SHOTWELL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941101323",
            "telephone_number": "415-522-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INIGUEZ",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.