Individual provider Active NPI

Kimberly Muller

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1649706219
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F342645-1 Issued in NY
Practice address
423 E 23Rd St
New York, NY 10010-5011
Phone
(212) 686-7500
NPI assigned
May 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR19090800 NJ
Registered Nurse 163W00000X 717945 NY
Family Nurse Practitioner 363LF0000X F342645-1 NY Primary

Addresses

Primary practice location

423 E 23Rd St
New York, NY 10010-5011

Mailing address

263 7TH Ave Ste 4a
Brooklyn, NY 11215-3693
Phone (718) 246-8614

Other practice location 1

1 Harvey Ave
Staten Island, NY 10314-2123
Phone (718) 494-4360

Other practice location 2

263 7th Ave Ste 4A
Brooklyn, NY 11215
Phone (718) 246-8614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180801002942 NY Practitioner - Nurse Practitioner 2567710908 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR19090800NJMDRegistered Nurse
717945NYMDRegistered Nurse
F342645-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC CurrentSince Jun 24, 2018 Accepting new patients
Kings Physician Services, PC CurrentSince Jun 24, 2018 Accepting new patients

Locations

263 7th Ave
Ste 4A
Brooklyn, NY 11215
Phone (718) 246-8590

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

Organizations & group practices 2

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": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1649706219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 7TH AVE STE 4A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153693",
            "telephone_number": "718-246-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 E 23RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105011",
            "telephone_number": "212-686-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Harvey Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103142123",
            "country_code": "US",
            "telephone_number": "718-494-4360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 7th Ave Ste 4A",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11215",
            "country_code": "US",
            "telephone_number": "718-246-8614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLER",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR19090800",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "717945",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342645-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.