Tina Renee Kauderer, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-11175 Issued in OH

Practice address

1001 S Perry St Ste 104B
Castle Rock, CO 80104-1950

Phone

(720) 485-3178

NPI assigned

Jun 13, 2010

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 CO, LA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Raja Talluri MD a Professional Medical CorporationGroup PAC ID 6608817077, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, 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.

• Raja Talluri MD a Professional Medical Corporation

  • Rural Health Clinic/Center
  • Thibodaux, LA
  • NPI 1083727838

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Heartlight Family Clinic, LLC

  • Primary Care Clinic/Center
  • Castle Rock, CO
  • NPI 1639529738
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Thibodaux Regional Health System Inc

  • General Acute Care Hospital
  • Thibodaux, LA
  • NPI 1902465065
  Care Compare affiliation

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

{
    "created_epoch": "1276387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1366763468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S PERRY ST STE 104B",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S PERRY ST STE 104B",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041950",
            "telephone_number": "720-485-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUDERER",
        "first_name": "TINA",
        "middle_name": "RENEE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-13",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0995983-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP-11175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Joyce Kary
• Kimberly Kristin Duried Kassab
• Louis Baird Kasunic, D.O.
• Benjamin Farrel Katz, MD
• Niki Crystal Katzenmeier, D.C.
• Brittany Morgan Kay, PT, DPT
• KBG Behavior Therapy
• KC Construction, Inc
• KC Medical PC
• Mandip KC, MD

• Family Nurse Practitioner in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.