Jacqueline Marie Kirk

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

F306406-1 Issued in NY

Practice address

7901 Broadway Anex O 3Rd Floor
Elmhurst, NY 11373

Phone

(718) 334-3148

NPI assigned

Sep 10, 2013

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacquelinekirk@imppllc.allscriptsdirect.net

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.

• Integrated Medical Professionals PLLC

  • Urology Physician
  • Lake Success, NY
  • NPI 1346203536
  Medicare reassignment NPD
• Integrated Medical Professionals PLLC

  • Durable Medical Equipment & Medical Supplies
  • New York, NY
  • NPI 1295534626
  NPD

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1720413743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BARBERRY LANE",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "11579",
            "telephone_number": "516-674-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY ANEX O 3RD FLOOR",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-334-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "F306406-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kinetix Professional Management, Inc.
• Kinetix Professional Management, Inc.
• Victoria C N King, M.S. CCC-SLP
• Kings Optical,Inc
• Ernest H. Kirchman, M.D.
• Svetlana Kirmayer, AUD
• Ramakrishnan Kizhakkancherry Ganesh, MD
• Nancy Norzin Dorjee Klein, NP
• Josh Kleinmuntz, LCSW
• Malgorzata Klek, MD

• Women's Health Nurse Practitioner in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Women's Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.