Active NPI
Kim Czerwinski, APRN, GNP-C
- Nurse Practitioner
- Pembroke Pines, FL
National Provider Identifier
1760959811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN11000009
- Practice address
- 880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171 - Phone
- (866) 849-0692
- Fax
- (888) 973-8821
- NPI assigned
- Oct 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 24690 | SC | |
| Nurse Practitioner | 363L00000X | 36316 | TN | |
| Nurse Practitioner | 363L00000X | GAA-NP000927 | GA | |
| Nurse Practitioner | 363L00000X | 0024180481 | VA | |
| Nurse Practitioner | 363L00000X | APRN11000009 | FL | Primary |
| Nurse Practitioner | 363L00000X | 3-001005 | AL | |
| Nurse Practitioner | 363L00000X | APRN.CNP.0036185 | OH | |
| Nurse Practitioner | 363L00000X | 1020375 | TX | |
| Nurse Practitioner | 363L00000X | 5014811 | NC |
Addresses
Primary practice location
880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171
Mailing address
PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692
Other practice location 1
386 SE Cork Rd
Port St Lucie, FL 34984-6309
Phone (772) 323-3073
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, NC, AL, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 4
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36316 | TN | MD | Pharmacist |
| 3-001005 | AL | MD | Nurse Practitioner |
| GAA-NP000927 | GA | MD | Nurse Practitioner |
| APRN.CNP.0036185 | OH | MD | Nurse Practitioner |
| 24690 | SC | MD | Nurse Practitioner |
| 1020375 | TX | MD | Nurse Practitioner |
| 0024180481 | VA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carelon Medical Partners of Kansas, PA | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Nashville, TN
- NPI 1124443403
SC
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Leawood, KS
- NPI 1952831422
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731974400000",
"number": "1760959811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 211699",
"city": "EAGAN",
"state": "MN",
"postal_code": "551213699",
"telephone_number": "866-849-0692",
"fax_number": "888-973-8821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "880 SW 145TH AVE STE 202",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330276171",
"telephone_number": "866-849-0692",
"fax_number": "888-973-8821"
}
],
"practiceLocations": [
{
"address_1": "386 SE Cork Rd",
"address_purpose": "LOCATION",
"city": "Port St Lucie",
"state": "FL",
"postal_code": "349846309",
"country_code": "US",
"telephone_number": "772-323-3073",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CZERWINSKI",
"first_name": "KIM",
"credential": "APRN, GNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-26",
"last_updated": "2024-11-19",
"certification_date": "2024-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "24690",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TN",
"license": "36316",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "GAA-NP000927",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "VA",
"license": "0024180481",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "APRN11000009",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "3-001005",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "APRN.CNP.0036185",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "1020375",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5014811",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.