Kimberly Rudnicki, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017201 Issued in CA

Practice address

1216 Suncast LN Ste 1
El Dorado Hills, CA 95762-9668

Phone

(916) 292-9777

NPI assigned

Jun 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: krudnicki126793@hpmg.direct-ci.net

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.

• Mimi K. Sato-Re, MD Medical Corporation

  • Primary Care Clinic/Center
  • Folsom, CA
  • NPI 1699945063
  Medicare reassignment

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1376110882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 CANBERRA PL",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957625362",
            "telephone_number": "916-216-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 SUNCAST LN STE 1",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629668",
            "telephone_number": "916-292-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNICKI",
        "first_name": "KIMBERLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason A Roth, DDS
• Maria Roush
• Royal Garden
• Ariela Rozegold, L.AC.
• Naara Yessenia Rubio Martinez
• Patrick A Rufo, DDS
• Judith Ruiz Novoa
• Nicole Angelynne Rymer Clark, SUDRC
• S. Jang DDS Incorporated
• S. Van Derwood, Licensed Clinical Social Worker, Inc

• Family Nurse Practitioner in El Dorado Hills, CA
• Providers in El Dorado Hills, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.