Individual provider Active NPI

Kaily Saltaformaggio

  • Family Nurse Practitioner
  • Kemah, TX
National Provider Identifier
1356101620
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1152878 Issued in TX
Practice address
702 E Shore Dr
Kemah, TX 77565-2519
Phone
(832) 561-5986
NPI assigned
Mar 21, 2024
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 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 1152878 TX Primary

Addresses

Primary practice location

702 E Shore Dr
Kemah, TX 77565-2519

Mailing address

702 E Shore Dr
Kemah, TX 77565-2519
Phone (832) 561-5986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240411002447 TX Practitioner - Nurse Practitioner 9739528654 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Apr 29, 2024 Accepting new patients
University of Texas Medical Branch at Galveston PastSince Apr 29, 2024 Accepting new patients

Locations

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

195 N 11th St
Beaumont, TX 77702
Phone (409) 838-0045

701 E Davis St
Ste A
Conroe, TX 77301
Phone (936) 525-2800

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

2750 Broadway St
Pearland, TX 77581
Phone (281) 448-5322

9300 Emmett F Lowry Expy
Ste 138
Texas City, TX 77591
Phone (409) 486-9686

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1356101620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 E SHORE DR",
            "city": "KEMAH",
            "state": "TX",
            "postal_code": "775652519",
            "telephone_number": "832-561-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 E SHORE DR",
            "city": "KEMAH",
            "state": "TX",
            "postal_code": "775652519",
            "telephone_number": "832-561-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALTAFORMAGGIO",
        "first_name": "KAILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1152878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kemah, TX

Sources for this page

Verify at the official NPI Registry.