Individual provider Active NPI

Kimberly Joseph-Persaud

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1649803974
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345578 Issued in NY
Practice address
754 E 151St St
Bronx, NY 10455-3267
Phone
(718) 684-9422
NPI assigned
Feb 14, 2020
Last updated
Feb 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345578 NY Primary

Addresses

Primary practice location

754 E 151St St
Bronx, NY 10455-3267

Mailing address

437 White Plains Rd
Bronx, NY 10473-2440

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
I20200515002293 NY Practitioner - Nurse Practitioner 1759712292 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun River Health Inc.Group PAC ID 6608783568, shared by 3 NPIs, 246 clinicians
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

1037 Main St
Peekskill, NY 10566-2913
Phone (914) 734-8800

1200 Brown St
Peekskill, NY 10566-2913

3379 Crompond Rd
Yorktown Heights, NY 10598-3605
Phone (914) 930-5550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
345578NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvoair Medical PC CurrentSince May 1, 2024 Accepting new patients
Westchester Health Medical, P.C. CurrentSince Jul 19, 2023 Accepting new patients
Divinity Medical Services PLLC CurrentSince Mar 1, 2024 Accepting new patients
Westchester Health Medical, P.C. CurrentSince Jul 19, 2023 Accepting new patients
Nuvoair Medical PC CurrentSince May 1, 2024 Accepting new patients

Locations

91 Smith Ave
Mount Kisco, NY 10549
Phone (914) 241-1717

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

510 Clinton Sq
Rochester, NY 14604
Phone (561) 208-1970

691 Old Route 6
Shrub Oak, NY 10588
Phone (914) 245-2270

3379 Crompond Rd
Yorktown Hts, NY 10598
Phone (914) 245-1111

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1649803974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 E 151ST ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104553267",
            "telephone_number": "718-684-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH-PERSAUD",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.