Individual provider Active NPI

Bisharjana Kafle, NP

  • Gerontology Nurse Practitioner
  • Austin, TX
National Provider Identifier
1770024218
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP132511 Issued in TX
Practice address
823 Congress Ave Ste 150-518
Austin, TX 78701-2405
Phone
(888) 380-0988
Fax
(289) 236-3022
NPI assigned
Mar 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP132511 TX Primary
Adult Health Nurse Practitioner 363LA2200X AP132511 TX

Addresses

Primary practice location

823 Congress Ave Ste 150-518
Austin, TX 78701-2405

Mailing address

2950 Buskirk Ave Ste 300
Walnut Creek, CA 94597-6900
Phone (888) 380-0988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200410000555 TX Practitioner - Nurse Practitioner 2668801788 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132511TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsom Clinic PA CurrentSince Dec 1, 2019 Accepting new patients
Wellmed Medical Group, PA Past Accepting new patients

Locations

1202 W Pioneer Dr
Ste 100
Irving, TX 75061
Phone (972) 254-7272

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.

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1770024218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 BUSKIRK AVE STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945976900",
            "telephone_number": "888-380-0988",
            "fax_number": "289-236-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 CONGRESS AVE STE 150-518",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012405",
            "telephone_number": "888-380-0988",
            "fax_number": "289-236-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAFLE",
        "first_name": "BISHARJANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP132511",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP132511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.