Organization Active NPI

FK NP in Family Health PLLC

  • Family Nurse Practitioner
  • Far Rockaway, NY
National Provider Identifier
1609757467
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
FK NP IN FAMILY HEALTH PLLC
Practice address
1328 Trist PL
Far Rockaway, NY 11691-1637
Phone
(718) 404-5592
NPI assigned
Sep 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Faiga Kimmel, NPNPI 1952745598
Title
President
Phone
(718) 404-5592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1328 Trist PL
Far Rockaway, NY 11691-1637

Mailing address

1328 Trist PL
Far Rockaway, NY 11691-1637
Phone (718) 404-5592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251105000075 NY Part B Supplier - Clinic/Group Practice 6608366091 Receives reassigned benefits from 1 practitioner
Practice locations: Far Rockaway, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2341184FK NP in Family Health PLLC1328 Trist Place, Far Rockaway, NY 11691Certificate of waiverMar 27, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1609757467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 TRIST PL",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911637",
            "telephone_number": "718-404-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 TRIST PL",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911637",
            "telephone_number": "718-404-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FK NP IN FAMILY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "FAIGA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-404-5592",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.