Individual provider Active NPI

Kristina Van Niel, PA-C

  • Medical Physician Assistant
  • Bremerton, WA
National Provider Identifier
1750863403
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61007880 Issued in WA
Practice address
400 Warren Ave
Bremerton, WA 98337-1487
Phone
(360) 337-3776
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT00001179 WA
Medical Physician Assistant 363AM0700X PA61007880 WA Primary
Physician Assistant 363A00000X PA61007880 WA
Physical Rehabilitation Occupational Therapist 225XP0019X OT00001179 WA

Addresses

Primary practice location

400 Warren Ave
Bremerton, WA 98337-1487

Mailing address

400 Warren Ave Ste 200
Bremerton, WA 98337-1467
Phone (360) 337-3776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20200215000167 WA Practitioner - Physician Assistant 4587090378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

616 6TH St
Bremerton, WA 98337-1420
Phone (360) 377-3776

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OT00001179WAMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Community Health Services CurrentSince Jan 27, 2022 Accepting new patients
Peninsula Community Health Services Physician Assistant CurrentSince Jan 27, 2022 Accepting new patients
Peninsula Community Health Services Physician Assistant Past Accepting new patients

Locations

300 E Campus Dr
Belfair, WA 98528
Phone (360) 277-2302

31 NE State Route 300
Ste 200
Belfair, WA 98528
Phone (360) 377-3779

5455 Almira Dr NE
Bremerton, WA 98311
Phone (360) 373-5031

616 6th St
Bremerton, WA 98337
Phone (360) 478-2366

8107 Central Valley Rd NE
Bremerton, WA 98311

2442 Perry Ave
Bremerton, WA 98310

11901 137th Ave NW
Unit A
Gig Harbor, WA 98329
Phone (253) 649-0696

25989 Barber Cut Off Rd NE
Kingston, WA 98346
Phone (360) 297-2844

320 S Kitsap Blvd
Port Orchard, WA 98366
Phone (360) 876-7215

19917 7th Ave NE
Ste 205
Poulsbo, WA 98370
Phone (360) 697-7636

627 W Franklin St
Shelton, WA 98584
Phone (360) 427-8940

3100 NW Bucklin Hill Rd
Ste 202
Silverdale, WA 98383
Phone (360) 377-3773

Interoperability endpoints

  • Direct secure messaging: kristina.van.niel.1@13902.direct.athenahealth.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.

Hospital & facility affiliations 1

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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1750863403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WARREN AVE STE 200",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983371467",
            "telephone_number": "360-337-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WARREN AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983371487",
            "telephone_number": "360-337-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NIEL",
        "first_name": "KRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT00001179",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61007880",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61007880",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "WA",
            "license": "OT00001179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.