Individual provider Active NPI

Kimberly E McDonald

  • Nurse Practitioner
  • Bridgewater, NJ
National Provider Identifier
1447933593
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ14885400 Issued in NJ
Practice address
1125 Route 22 Ste 265
Bridgewater, NJ 08807-2939
Phone
(973) 971-7507
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ14885400 NJ
Gerontology Nurse Practitioner 363LG0600X 26NJ14885400 NJ
Primary Care Nurse Practitioner 363LP2300X 26NJ14885400 NJ
Nurse Practitioner 363L00000X 26NJ14885400 NJ Primary

Addresses

Primary practice location

1125 Route 22 Ste 265
Bridgewater, NJ 08807-2939

Mailing address

237 Morris Ave Apt 1
Summit, NJ 07901-5502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20231113000275 NJ Practitioner - Nurse Practitioner 4789031816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

1125 US Hwy 22
Suite 170
Bridgewater, NJ 08807-2939
Phone (908) 947-7011

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Oct 30, 2023 Accepting new patients

Locations

1125 US Highway 22
Ste 265
Bridgewater, NJ 08807
Phone (908) 522-5045

1125 US Highway 22
Ste 170
Bridgewater, NJ 08807
Phone (908) 947-7010

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

435 South St
Ste 200
Morristown, NJ 07960
Phone (973) 630-2250

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1447933593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 MORRIS AVE APT 1",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079015502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 ROUTE 22 STE 265",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072939",
            "telephone_number": "973-971-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "KIMBERLY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ14885400",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ14885400",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ14885400",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ14885400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.