Individual provider Active NPI

Kristine Kesselman, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • Brick, NJ
National Provider Identifier
1689349227
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
26NR14545600 Issued in NJ
Practice address
495 Jack Martin Blvd Ste 6
Brick, NJ 08724-7778
Phone
(732) 344-0596
NPI assigned
Aug 16, 2021
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 26NR14545600 NJ Primary

Addresses

Primary practice location

495 Jack Martin Blvd Ste 6
Brick, NJ 08724-7778

Mailing address

495 Jack Martin Blvd Ste 6
Brick, NJ 08724-7778
Phone (732) 344-0596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NR14545600NJMDAddiction (Substance Use Disorder) Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Monmouth Healthcare Services CurrentSince Aug 28, 2021 Accepting new patients

Locations

495 Jack Martin Blvd
Ste 6
Brick, NJ 08724
Phone (732) 344-0596

Organizations & group practices 1

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1689349227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 JACK MARTIN BLVD STE 6",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247778",
            "telephone_number": "732-344-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 JACK MARTIN BLVD STE 6",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247778",
            "telephone_number": "732-344-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSELMAN",
        "first_name": "KRISTINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "26NR14545600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.