Individual provider Active NPI

Kerstin J Cmok, APRN

  • Adult Health Nurse Practitioner
  • Arlington, MA
National Provider Identifier
1548599491
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2263034 Issued in MA
Practice address
22 Mill St
Ste 310
Arlington, MA 02476-4784
Phone
(781) 643-0500
Fax
(781) 648-8509
NPI assigned
Dec 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2263034 MA Primary

Addresses

Primary practice location

22 Mill St
Ste 310
Arlington, MA 02476-4784

Mailing address

22 Mill St
Ste 310
Arlington, MA 02476-4784
Phone (781) 643-0500

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
I20110126000530 MA Practitioner - Nurse Practitioner 6709852163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barry S Paul, M.D.Group PAC ID 7517027709, 3 clinicians

Practice addresses (Care Compare)

22 Mill St
Arlington, MA 02476-4744
Phone (781) 643-0500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2263034MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barry S Paul, M.D. CurrentSince Nov 2, 2010 Accepting new patients

Locations

22 Mill St
Ste 310
Arlington, MA 02476
Phone (781) 643-0500

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.

NPI Registry JSON

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1548599491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MILL ST",
            "address_2": "STE 310",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024764784",
            "telephone_number": "781-643-0500",
            "fax_number": "781-648-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MILL ST",
            "address_2": "STE 310",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024764784",
            "telephone_number": "781-643-0500",
            "fax_number": "781-648-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CMOK",
        "first_name": "KERSTIN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2263034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MA

Sources for this page

Verify at the official NPI Registry.