Individual provider Active NPI

Kristin Lynn Gambardella, CNM

  • Advanced Practice Midwife
  • Nyack, NY
National Provider Identifier
1447927520
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F002092 Issued in NY
Practice address
160 N Midland Ave
Nyack, NY 10960-1912
Phone
(845) 348-2000
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F002092 NY Primary

Addresses

Primary practice location

160 N Midland Ave
Nyack, NY 10960-1912

Mailing address

2325 Crescent St
Astoria, NY 11105-3107
Phone (914) 262-1152

Other practice location 1

258 High Ave
Nyack, NY 10960-2407
Phone (845) 348-2550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
002092NYMDDance Therapist
F002092NYMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1447927520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 CRESCENT ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111053107",
            "telephone_number": "914-262-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N MIDLAND AVE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601912",
            "telephone_number": "845-348-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "258 High Ave",
            "address_purpose": "LOCATION",
            "city": "Nyack",
            "state": "NY",
            "postal_code": "109602407",
            "country_code": "US",
            "telephone_number": "845-348-2550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBARDELLA",
        "first_name": "KRISTIN",
        "middle_name": "LYNN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F002092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.