Imtithal Kisirwan, APRN, AGACNP, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11046769 Issued in FL

Practice address

3100 Weston Rd
Weston, FL 33331-3602

Phone

(954) 659-5000

NPI assigned

May 3, 2017

Last updated

Jul 14, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MN

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

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ikisirwan136310@ehrdirect.mayoclinicmsg.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mayo Clinic

  • Multi-Specialty Clinic/Center
  • Rochester, MN
  • NPI 1922074434
  Medicare reassignment Care Compare group NPD
• Mayo Clinic

  • Clinical Medical Laboratory
  • Rochester, MN
  • NPI 1083249577
  NPD
• Mayo Clinic

  • Multi-Specialty Clinic/Center
  • Rochester, MN
  • NPI 1538568928
  NPD

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

• Mayo Clinic Hospital-Rochester

  • General Acute Care Hospital
  • Rochester, MN
  • NPI 1841266194
  Care Compare affiliation

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1518493196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 WESTON RD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313602",
            "telephone_number": "954-659-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 WESTON RD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313602",
            "telephone_number": "954-659-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "fax_number": "507-284-0702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISIRWAN",
        "first_name": "IMTITHAL",
        "credential": "APRN, AGACNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP5149",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11046769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylore Anna King, MD
• Anna Khachaturovna Kirakosian, MHC, PHD
• Penelope Kirkiles
• Jacobo Kirsch, MD
• Samantha Kirschner
• Vandhana Bhagwan Kiswani-Barley, M.D.
• Lauren Kittel Brickman, PSY.D.
• Michelle Klainbaum
• Savannah Kay-Lee Klee
• Beth Klein, PHD

• Nurse Practitioner in Weston, FL
• Providers in Weston, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.