Individual provider Active NPI

Kristen Marie Zimbardi, NP

  • Family Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1649288440
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP07195 Issued in OH
Practice address
17876 Saint Clair Ave
Cleveland, OH 44110-2602
Phone
(216) 383-2222
Fax
(216) 298-0241
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 286828 OH
Family Nurse Practitioner 363LF0000X NP07195 OH Primary

Addresses

Primary practice location

17876 Saint Clair Ave
Cleveland, OH 44110-2602

Mailing address

17876 Saint Clair Ave
Cleveland, OH 44110-2602
Phone (216) 383-2222

Other names 1

  • Ms. Kristen Marie Costello Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140625000323 OH Practitioner - Nurse Practitioner 7315162807 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

Practice addresses (Care Compare)

17876 Saint Clair Ave
Cleveland, OH 44110-2602

19194 Bowman Dr
Strongsville, OH 44149-5933
Phone (440) 488-4774

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN 286828OHMDRegistered Nurse
NP07195OHMDFamily Nurse Practitioner

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1649288440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17876 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441102602",
            "telephone_number": "216-383-2222",
            "fax_number": "216-298-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17876 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441102602",
            "telephone_number": "216-383-2222",
            "fax_number": "216-298-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMBARDI",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN 286828",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP07195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "COSTELLO",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.