Individual provider Active NPI

Kimberly Evangelista Lundquist, ARNP, FNP-BC

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1649564642
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9262739 Issued in FL
Practice address
1400 S Orange Ave
Orlando, FL 32806-2134
Phone
(407) 648-3800
Fax
(407) 425-5203
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9262739 FL
Adult Health Nurse Practitioner 363LA2200X ARNP9262739 FL Primary

Addresses

Primary practice location

1400 S Orange Ave
Orlando, FL 32806-2134

Mailing address

1400 S Orange Ave
Orlando, FL 32806-2134
Phone (407) 648-3800

Other identifiers 1

IdentifierTypeStateIssuer
004273000MedicaidFL

Other names 1

  • Kimberly Lynn Evangelista Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120103000239 FL Practitioner - Nurse Practitioner 8123294782 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1400 S Orange Ave
Orlando, FL 32806-2134
Phone (321) 841-6600

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2023 Accepting new patients
Apogee Medical Group, Florida Inc CurrentSince Aug 1, 2021 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1400 S Orange Ave
Orlando, FL 32806
Phone (321) 841-1893

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

Organizations & group practices 4

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": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1649564642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062134",
            "telephone_number": "407-648-3800",
            "fax_number": "407-425-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062134",
            "telephone_number": "407-648-3800",
            "fax_number": "407-425-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDQUIST",
        "first_name": "KIMBERLY",
        "middle_name": "EVANGELISTA",
        "name_prefix": "Ms.",
        "credential": "ARNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9262739",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9262739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004273000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "EVANGELISTA",
            "middle_name": "LYNN",
            "credential": "ARNP, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.