Individual provider Active NPI

Kimberly A Molinari, CRNP

  • Adult Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1750644241
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP014184 Issued in PA
Practice address
3400 Civic Center Blvd.
Pcam Rowan Breast Center
Philadelphia, PA 19104
Phone
(215) 615-5858
Fax
(856) 769-7959
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2NR14615100 NJ
Adult Health Nurse Practitioner 363LA2200X SP014184 PA Primary
Adult Health Nurse Practitioner 363LA2200X 26NJ00386700 NJ

Addresses

Primary practice location

3400 Civic Center Blvd.
Pcam Rowan Breast Center
Philadelphia, PA 19104

Mailing address

3400 Civic Center Blvd.
Pcam Rowan Breast Center
Philadelphia, PA 19104
Phone (215) 615-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 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
I20140327000842 NJ Practitioner - Nurse Practitioner 3971734310 Reassigns benefits to 1 organization
I20141224000119 PA Practitioner - Nurse Practitioner 3971734310 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 662-3606

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2NR14615100NJMDAdult Health Nurse Practitioner
SP014184PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Feb 8, 2014 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Nov 18, 2014 Accepting new patients
Virtua Medical Group, PA CurrentSince Feb 8, 2014 Accepting new patients
University of Penn-Medical Group CurrentSince Nov 18, 2014 Accepting new patients
University of Penn - Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Oct 1, 2025 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1750644241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD.",
            "address_2": "PCAM ROWAN BREAST CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-615-5858",
            "fax_number": "856-769-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD.",
            "address_2": "PCAM ROWAN BREAST CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-615-5858",
            "fax_number": "856-769-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINARI",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "2NR14615100",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP014184",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00386700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.