Individual provider Active NPI

Kathleen Beltran, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1407234503
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339553-1 Issued in NY
Practice address
1030 Sheridan Ave
Bronx, NY 10456-6100
Phone
(718) 410-3400
Fax
(718) 410-4643
NPI assigned
May 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 F339553-1 NY Primary

Addresses

Primary practice location

1030 Sheridan Ave
Bronx, NY 10456-6100

Mailing address

1855 Corporal Kennedy St Apt 2E
Bayside, NY 11360-1436
Phone (718) 410-3400

Other names 1

  • Kathleen Beltran Dimacuha Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150731014482 NY Practitioner - Nurse Practitioner 8224342571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somos Medical PCGroup PAC ID 6406217868, 10 clinicians

Practice addresses (Care Compare)

44 Sherman Ave
New York, NY 10040-1104
Phone (833) 717-2828

571 Academy St
Apt 1a
New York, NY 10034-5105

610 Academy St
Suite 10a
New York, NY 10034-5058
Phone (833) 717-2828

620 W 190TH St
New York, NY 10040-4157
Phone (833) 717-2828

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
339553NYMDLicensed Practical Nurse
F339553-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shining Light Family Health NP PC CurrentSince Jan 1, 2019 Accepting new patients
Simela Medical Arts PC CurrentSince May 26, 2018 Accepting new patients
City Heart Vascular PLLC Past Accepting new patients
Metropolis Medical PC Past Accepting new patients

Locations

2910 Exterior St
Fl 1
Bronx, NY 10463
Phone (212) 567-4918

1030 Sheridan Ave
Bronx, NY 10456
Phone (718) 410-3400

5030 Broadway
Ste 818
New York, NY 10034
Phone (212) 567-4931

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1407234503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 CORPORAL KENNEDY ST APT 2E",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601436",
            "telephone_number": "718-410-3400",
            "fax_number": "718-410-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 SHERIDAN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104566100",
            "telephone_number": "718-410-3400",
            "fax_number": "718-410-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339553-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "DIMACUHA",
            "middle_name": "BELTRAN",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.