Individual provider Active NPI

Maria Klimenko, NP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1700453594
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F310155-01 Issued in NY
Practice address
1044 5TH Ave
New York, NY 10028-0108
Phone
(212) 249-9440
NPI assigned
Jun 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F310155-01 NY Primary

Addresses

Primary practice location

1044 5TH Ave
New York, NY 10028-0108

Mailing address

1044 5TH Ave
New York, NY 10028-0108

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nurses@nylaserskincare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MO2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210623002570 NY Practitioner - Nurse Practitioner 9234530692 Reassigns benefits to 1 organization
I20250602002013 MO Practitioner - Nurse Practitioner 9234530692 Reassigns benefits to 1 organization

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
Vitalskin Medical Group Il PLLCGroup PAC ID 5991116261, 56 clinicians

Practice addresses (Care Compare)

1000 Des Peres Rd
Suite 301
Des Peres, MO 63131-2064
Phone (812) 944-7500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310155NYMDHospitalist Physician
F310155-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Derm Specs of PA PLLC CurrentSince Feb 25, 2024 Accepting new patients
Vitalskin Medical Group Il PLLC CurrentSince May 14, 2025 Accepting new patients
Century Medical & Dental Center Inc CurrentSince May 1, 2025 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients
Arielle N.B. Kauvar, M.D., P.C. PastSince Jun 15, 2021 Accepting new patients

Locations

1000 Des Peres Rd
Ste 301
Des Peres, MO 63131
Phone (812) 944-7500

621 S New Ballas Rd
Ste 5002B
Saint Louis, MO 63141
Phone (314) 432-3033

621 S New Ballas Rd
Ste 7008
Saint Louis, MO 63141

1000 Des Peres Rd
Ste 200
Saint Louis, MO 63131

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

1027 46th Ave
Fl 1
Long Island City, NY 11101

827 11th Ave
New York, NY 10019
Phone (212) 257-9778

2315 3rd Ave
New York, NY 10035
Phone (212) 369-5566

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1700453594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280108",
            "telephone_number": "212-249-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIMENKO",
        "first_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310155-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nurses@nylaserskincare.com",
            "affiliation": "N",
            "address_1": "1044 5th Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100280108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.