NPIMap

Individual provider Active NPI

Kristen Klabacha, FNP

  • Family Nurse Practitioner
  • Lutz, FL
National Provider Identifier
1790117992
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9361336 Issued in FL
Practice address
17900 Hunting Bow Cir Ste 101
Lutz, FL 33558-5390
Phone
(813) 765-2273
NPI assigned
Jul 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9361336 FL Primary

Addresses

Primary practice location

17900 Hunting Bow Cir Ste 101
Lutz, FL 33558-5390

Mailing address

8191 W Brinkland Cir
Minocqua, WI 54548-8940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180509002257 WI Practitioner - Nurse Practitioner 4082858725 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians

Practice addresses (Care Compare)

401 W Mohawk Dr
Tomahawk, WI 54487-2274
Phone (715) 453-7200

425 Pine Ridge Blvd
Wausau, WI 54401-4123
Phone (715) 843-1067

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.84 of 100Reported as group
Quality
86.21
Promoting interoperability
100
Improvement activities
40
Cost
73.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9361336FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marshfield Clinic Inc CurrentSince Apr 30, 2018 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 30, 2018 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jan 6, 2026 Accepting new patients
Aspirus Eagle River Hospital & Clinics, Inc. CurrentSince May 15, 2023 Accepting new patients
Aspirus Eagle River Hospital, Inc. CurrentSince May 15, 2023 Accepting new patients
Florida Specialty Dermatology Care LLC CurrentSince Sep 6, 2013 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince May 15, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 30, 2018 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince May 15, 2023 Accepting new patients
The Howard Young Medical Center, Inc. CurrentSince Jul 30, 2020 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jan 6, 2026 Accepting new patients

Locations

400 N Tampa St
Ste 1100
Tampa, FL 33602
Phone (813) 275-9100

29980 Network Pl
Chicago, IL 60673

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1020 Kabel Ave
Rhinelander, WI 54501
Phone (715) 361-2805

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

2251 N Shore Dr
Rhinelander, WI 54501
Phone (715) 361-2300

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

401 W Mohawk Dr
Tomahawk, WI 54487
Phone (715) 453-7200

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

425 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2400

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Organizations & group practices 12

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1790117992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8191 W BRINKLAND CIR",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545488940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 HUNTING BOW CIR STE 101",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585390",
            "telephone_number": "813-765-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLABACHA",
        "first_name": "KRISTEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9361336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.