Kimberly Dawn Pettinelli, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

129504-7 Issued in MN

Practice address

3605 Mayfair Ave
Hibbing, MN 55746-2935

Phone

(218) 262-3441

Fax

(218) 362-6908

NPI assigned

May 20, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Range Regional Health Services Hospital, Hibbing, MN, CCN 240040
• Cook Hospital Hospital, Cook, MN, CCN 241312

Merit-based Incentive Payment System (MIPS)

Final score

96.93 of 100Reported as group

Quality

94.88

Promoting interoperability

100

Improvement activities

40

Cost

78.21

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpettinelli315846@fairview.direct-ci.com

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.

• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment Care Compare group NPD
• Range Regional Health Services

  • Durable Medical Equipment & Medical Supplies
  • International Falls, MN
  • NPI 1710954821
  NPD
• Range Regional Health Services

  • General Acute Care Hospital
  • Hibbing, MN
  • NPI 1356321699
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cook Hospital

  • Critical Access Hospital
  • Cook, MN
  • NPI 1992763858
  Care Compare affiliation
• Range Regional Health Services

  • General Acute Care Hospital
  • Hibbing, MN
  • NPI 1356321699
  Care Compare affiliation

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1659664852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 MAYFAIR AVE",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462935",
            "telephone_number": "218-262-3441",
            "fax_number": "218-362-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 MAYFAIR AVE",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462935",
            "telephone_number": "218-262-3441",
            "fax_number": "218-362-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINELLI",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "129504-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659664852",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICARE NUMBER PTAN",
            "identifier": "500006831",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Anne Peterson, PHARMD
• Craig M Petroske
• Jennifer Petroske, PHARMD
• Shannon Rose Petroske, NP
• Gina Marie Pettinari, CRNA
• PJ Noss LLC
• Bernadette J Pospeck, MSW, LICSW
• Richard A Pounds, MD
• Premier Physical Healthcare PLLC
• Sara Procopio, LADC

• Nurse Practitioner in Hibbing, MN
• Providers in Hibbing, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.