Individual provider Active NPI

Kaitlin Ann Zambotti, APRN

  • Family Nurse Practitioner
  • Titusville, FL
National Provider Identifier
1700294238
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004270 Issued in FL
Practice address
1537 N Singleton Ave
Titusville, FL 32796-1679
Phone
(321) 241-6800
Fax
(321) 241-6890
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP014043 PA
Family Nurse Practitioner 363LF0000X APRN11004270 FL Primary

Addresses

Primary practice location

1537 N Singleton Ave
Titusville, FL 32796-1679

Mailing address

PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696

Other identifiers 1

IdentifierTypeStateIssuer
107641100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240404000486 FL Practitioner - Nurse Practitioner 0143440545 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11004270FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Health Alliance Inc CurrentSince Jan 30, 2024 Accepting new patients
Brevard Health Alliance, Inc. CurrentSince Jan 30, 2024 Accepting new patients
Brevard Health Alliance Inc Current Accepting new patients
Brevard Health Alliance Inc Past Accepting new patients

Locations

775 Malabar Rd
Malabar, FL 32950
Phone (321) 722-8435

17 Silver Palm Ave
Melbourne, FL 32901
Phone (321) 725-9041

2120 Sarno Rd
Melbourne, FL 32935
Phone (321) 952-9696

5270 Babcock St NE
Ste 1
Palm Bay, FL 32905
Phone (321) 722-5959

7227 N US Highway 1
Port St John, FL 32927
Phone (321) 631-3693

1537 N Singleton Ave
Titusville, FL 32796
Phone (321) 268-0267

Interoperability endpoints

  • Direct secure messaging: kaitlin.zambotti@bha.eclinicaldirectplus.com

Organizations & group practices 4

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": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1700294238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021137",
            "telephone_number": "321-952-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 N SINGLETON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327961679",
            "telephone_number": "321-241-6800",
            "fax_number": "321-241-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMBOTTI",
        "first_name": "KAITLIN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014043",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107641100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.