Individual provider Active NPI

Kimberly Ann Guibone, ACNP

  • Acute Care Nurse Practitioner
  • Boston, MA
National Provider Identifier
1427279330
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN188286 Issued in MA
Practice address
185 Pilgrim Rd
Palmer 216
Boston, MA 02215-5324
Phone
(617) 632-9729
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN188286 MA Primary

Addresses

Primary practice location

185 Pilgrim Rd
Palmer 216
Boston, MA 02215-5324

Mailing address

5 Koper LN
Pelham, NH 03076-2608
Phone (603) 890-0144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20110817000676 MA Practitioner - Nurse Practitioner 2961568209 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN188286MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jun 9, 2011 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 9, 2011 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jun 9, 2011 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 9, 2011 Accepting new patients

Locations

185 Pilgrim Rd
#216
Boston, MA 02215
Phone (617) 632-9729

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Interoperability endpoints

  • Direct secure messaging: kguibone255093@direct.bilh.masshiway.net

Organizations & group practices 4

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1427279330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 KOPER LN",
            "city": "PELHAM",
            "state": "NH",
            "postal_code": "030762608",
            "telephone_number": "603-890-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 PILGRIM RD",
            "address_2": "PALMER 216",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155324",
            "telephone_number": "617-632-9729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIBONE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN188286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.