Individual provider Active NPI

Kimberly Ann Moniz, NP

  • Adult Health Nurse Practitioner
  • Fairhaven, MA
National Provider Identifier
1558794651
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
275774 Issued in MA
Practice address
200 Mill Road
Suite 180
Fairhaven, MA 02719
Phone
(508) 973-2160
Fax
(508) 973-2176
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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 275774 MA Primary

Addresses

Primary practice location

200 Mill Road
Suite 180
Fairhaven, MA 02719

Mailing address

200 Mill Road
Suite 180
Fairhaven, MA 02719-5252
Phone (508) 973-3000

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
I20140401001883 MA Practitioner - Nurse Practitioner 7618108887 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prima Care, PCGroup PAC ID 2567356017, 222 clinicians

Practice addresses (Care Compare)

289 Pleasant St
Suite 301
Fall River, MA 02721-3005
Phone (508) 679-9955

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
275774MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare Medical Group Inc CurrentSince May 1, 2023 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 1, 2021 Accepting new patients
Martha'S Vineyard Hospital Current Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince Nov 20, 2019 Accepting new patients
Revere Medical of Massachusetts, PC CurrentSince Oct 30, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 1, 2021 Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince Nov 20, 2019 Accepting new patients
Premier Healthcare Services, LLC Past Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

1 Pearl St
Ste 1000
Brockton, MA 02301
Phone (508) 897-6050

851 Middle St
Ste 3400
Fall River, MA 02721
Phone (508) 235-5400

277 Pleasant St
Fl 4
Fall River, MA 02721
Phone 50867632921244

289 Pleasant St
Ste 601
Fall River, MA 02721
Phone (508) 646-7730

851 Middle St
Ste 2400
Fall River, MA 02721
Phone (508) 397-8791

289 Pleasant St
Bldg 4
Fall River, MA 02721
Phone (508) 675-3972

289 Pleasant St
Ste 301
Fall River, MA 02721
Phone (508) 324-3200

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

1 Hospital Rd
Oak Bluffs, MA 02557
Phone (508) 684-4500

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

9 Galen St
Ste 155
Watertown, MA 02472
Phone (857) 304-2444

Interoperability endpoints

  • Direct secure messaging: moniz.kimberly.mvh@direct.partners.masshiway.net

Organizations & group practices 9

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 1

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": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1558794651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL ROAD",
            "address_2": "SUITE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-3000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MILL ROAD",
            "address_2": "SUITE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "02719",
            "telephone_number": "508-973-2160",
            "fax_number": "508-973-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONIZ",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "275774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhaven, MA

Sources for this page

Verify at the official NPI Registry.