NPIMap

Individual provider Active NPI

Kristal L Imperio, NP

  • Nurse Practitioner
  • Leominster, MA
National Provider Identifier
1780650234
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
198129 Issued in MA
Practice address
165 Mill St
Leominster, MA 01453
Phone
(978) 466-3212
Fax
(978) 534-3581
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 198129 MA Primary

Addresses

Primary practice location

165 Mill St
Leominster, MA 01453

Mailing address

630 Plantation St
Worcester, MA 01605
Phone (978) 466-3212

Other identifiers 12

IdentifierTypeStateIssuer
4142192OtherMVP HEALTH CARE
NP3714OtherBLUE SHIELD HMO BLUE
NP3714OtherBLUE SHIELD INDEMNITY
042472266OtherTHREE RIVERS
0390411OtherWELFARE
0390411MedicaidMA
042472266OtherTRICARE
NP3714OtherBLUE CARE ELECT
042472266OtherPRIVATE HEALTHCARE SYSTEM
61994OtherFALLON COMMUNITY HEALTH P
042472266OtherCHAMPUS
AA3666OtherHARVARD PILGRIM HEALTHCAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190726000515 VT Practitioner - Nurse Practitioner 4789624214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cottage HospitalGroup PAC ID 1951219617, shared by 4 NPIs, 29 clinicians

Practice addresses (Care Compare)

103 Swiftwater Rd
Woodsville, NH 03785-1423
Phone (603) 747-2900

Hospital & facility affiliations

  • Vna and Hospice of Vermont and New Hampshire Home health agency, White River Junction, VT, CCN 477002
  • North Country Home Health & Hospice Agency Home health agency, Littleton, NH, CCN 307009
  • Cottage Hospital Hospital, Woodsville, NH, CCN 301301
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
198129MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Jul 22, 2019 Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Jul 22, 2019 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

195 Industrial Pkwy
Lyndonville, VT 05851

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

Organizations & group practices 3

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 8

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1780650234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "978-466-3212",
            "fax_number": "978-534-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MILL ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-3212",
            "fax_number": "978-534-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPERIO",
        "first_name": "KRISTAL",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "198129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "4142192",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HMO BLUE",
            "identifier": "NP3714",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "NP3714",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELFARE",
            "identifier": "0390411",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0390411",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE ELECT",
            "identifier": "NP3714",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH P",
            "identifier": "61994",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA3666",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.