Kimberly Centeio

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

RN2262475 Issued in MA

Practice address

69 Byron Ave
Brockton, MA 02301-4201

Phone

(774) 444-0269

NPI assigned

Jul 16, 2019

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 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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• High Point Treatment Center Inc.

  • Counselor
  • New Bedford, MA
  • NPI 1518996354
  Medicare reassignment NPD

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1598317935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 BYRON AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014201",
            "telephone_number": "774-444-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 BYRON AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014201",
            "telephone_number": "774-444-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENTEIO",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN2262475",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2262475",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johensky Etienne Celestin, LMHC
• Mischael Pierre Celestin
• Monique Celestin
• Richard Joseph Celli, DMD
• Vaturia S Cenatus, LPN
• Porfirio Centeio Jr.
• Tatiana Centeio, LPN
• Center City Chiropractic, Inc
• Center for Eye Health Inc
• Center for Eye Health, PLLC

• Primary Care Nurse Practitioner in Brockton, MA
• Providers in Brockton, MA by specialty
• Primary Care Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.