Kimberly Mae Carreon Carillo, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

308369 Issued in NY

Practice address

622 W 168TH St FL 14
New York, NY 10032-3720

Phone

(212) 305-0914

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Mae Ruiz Carreon Former name

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

Specialty

Nurse Practitioner

Education

New York University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

85.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD
• Trustees of Columbia University in the Department of Otolaryngology

  • Specialist
  • New York, NY
  • NPI 1801074315
  NPD (past)

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

• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1144504044
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • Ambulance
  • New York, NY
  • NPI 1174628473

  Hospital

  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1194832477
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • Bronxville, NY
  • NPI 1780196345
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1952332801
  Care Compare affiliation

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1407327687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 ROUTE 340",
            "city": "SPARKILL",
            "state": "NY",
            "postal_code": "109761205",
            "telephone_number": "845-596-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST FL 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARILLO",
        "first_name": "KIMBERLY MAE",
        "middle_name": "CARREON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F308369-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY MAE",
            "last_name": "CARREON",
            "middle_name": "RUIZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.