Kellie Boeggeman Dearden, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN355 Issued in SC

Practice address

885 3Rd Ave FL 28
New York, NY 10022-4834

Phone

(929) 650-3990

NPI assigned

Aug 1, 2007

Last updated

Apr 23, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC, NC, FL, CA, OH, VA, OR, WA, IN, LA10 enrollments

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 10

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dr Rebman Medical PAGroup PAC ID 3678087400, 88 clinicians

Ivy Medical Group PLLCGroup PAC ID 4981097797, 120 clinicians

Uptown Providers PCGroup PAC ID 4284891243, shared by 2 NPIs, 43 clinicians

Daniel Funsch Jr MD PCGroup PAC ID 1951801836, 139 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 26)

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Daniel Funsch Jr, M.D., P.C.

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1316784580

  FL

  Medicare reassignment Care Compare group NPD
• Ivy Medical Group PLLC

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1700558798

  FL, LA, NC, OH, VA

  Medicare reassignment Care Compare group NPD
• Dr Rebman Medical PA

  • Family Medicine Physician
  • Miami, FL
  • NPI 1669276689

  IN, OH, VA

  Medicare reassignment Care Compare group NPD
• Daniel Funsch Jr, M.D., Professional Corporation

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1376389163

  CA

  Medicare reassignment NPD
• Dr Medical Services PC

  • Multi-Specialty Clinic/Center
  • New York, NY
  • NPI 1053012401

  FL

  Medicare reassignment NPD
• Dr Rebman BH LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • New York, NY
  • NPI 1114894540

  FL, IN, OH, VA

  Medicare reassignment NPD
• Carolina Cardiology and Vascular Associates LLC

  • Cardiovascular Disease Physician
  • Irmo, SC
  • NPI 1912400300
  Medicare reassignment NPD
• Easy Health Medical Solutions PC

  • Nurse Practitioner
  • Fulton, MD
  • NPI 1972179141

  WA

  Medicare reassignment NPD
• Musc Community Physicians

  dba MUSC Community Physicians Specialty

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment NPD
• The Carolinas Emergency Group, PLLC

  • Emergency Medicine Physician
  • Dunn, NC
  • NPI 1477508836
  Medicare reassignment NPD
• Uptown Providers PC

  dba AFC Urgent Care

  • Urgent Care Clinic/Center
  • Vancouver, WA
  • NPI 1255102034
  Medicare reassignment NPD
• Uptown Providers PC

  dba AFC Urgent Care

  • Urgent Care Clinic/Center
  • Tigard, OR
  • NPI 1346903531
  Medicare reassignment NPD

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1669662086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16706 NE 98TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986821275",
            "fax_number": "803-888-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 3RD AVE FL 28",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224834",
            "telephone_number": "929-650-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARDEN",
        "first_name": "KELLIE",
        "middle_name": "BOEGGEMAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "248427",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "APN355",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9165739",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7006413",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1310",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Maria Deangelis, M.D.
• Ann Marie Deangelo
• Gabriella Tucci Deangelo
• Bertha Dear, RN
• Connor Matthew Dearborn
• Meagan Mary J Deardorff
• Helen Farrell Dearie
• Lee D Dearing, CRNA
• Anne Michelle Dearwater, PT, DPT
• Khadija Deas-Joseph, PHYSICIAN ASSISTANT

• Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.