Individual provider Active NPI

Krista Kirk, APN

  • Nurse Practitioner
  • Elmhurst, IL
National Provider Identifier
1366061616
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209022007 Issued in IL
Practice address
1200 S York St Ste 2000
Elmhurst, IL 60126-5634
Phone
(331) 221-9003
NPI assigned
Apr 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 041.416140 IL
Nurse Practitioner 363L00000X 209022007 IL Primary

Addresses

Primary practice location

1200 S York St Ste 2000
Elmhurst, IL 60126-5634

Mailing address

4201 Winfield Rd FL 3
Warrenville, IL 60555-4025
Phone (331) 221-6377

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkirk243466@direct.edward.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220113000328 IL Practitioner - Nurse Practitioner 7517359029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1200 S York Rd
Suite 1120
Elmhurst, IL 60126-5626
Phone (630) 527-3200

1200 S York St
Elmhurst, IL 60126-5626
Phone (331) 221-6636

155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (331) 221-0096

177 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (630) 646-6020

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041.416140ILMDCritical Care Medicine Registered Nurse
209022007ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 19, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 19, 2023 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Mar 7, 2022 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Mar 7, 2022 Accepting new patients
Wyse Eyecare SC Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

1200 S York St
Ste 2000
Elmhurst, IL 60126
Phone (331) 221-9002

133 E Brush Hill Rd
Ste 310
Elmhurst, IL 60126
Phone (331) 221-9003

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

4201 Winfield Rd
Fl 3
Warrenville, IL 60555

Organizations & group practices 5

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": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1366061616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WINFIELD RD FL 3",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554025",
            "telephone_number": "331-221-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST STE 2000",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265634",
            "telephone_number": "331-221-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "KRISTA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IL",
            "license": "041.416140",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkirk243466@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 S York St Ste 2000",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601265634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.