Individual provider Active NPI

Kimberly Ann Novenski

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1831817477
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
279094 Issued in AZ
Practice address
10101 N 92ND St Ste 101
Scottsdale, AZ 85258-4553
Phone
(480) 747-6532
Fax
(480) 889-6865
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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 279094 AZ Primary

Addresses

Primary practice location

10101 N 92ND St Ste 101
Scottsdale, AZ 85258-4553

Mailing address

10101 N 92ND St Ste 101
Scottsdale, AZ 85258-4553
Phone (480) 747-6532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20221020002141 AZ Practitioner - Nurse Practitioner 2860868536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nassim Haddad MD PLLCGroup PAC ID 6204084973, 11 clinicians

Practice addresses (Care Compare)

10101 N 92ND St
Suite 101
Scottsdale, AZ 85258-4553
Phone 4807476532105

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usha Medical Services PLC Current Accepting new patients
Nassim Haddad MD PLLC CurrentSince Oct 3, 2022 Accepting new patients

Locations

9445 E Ironwood Square Dr
Ste 110
Scottsdale, AZ 85258
Phone (480) 391-3686

10101 N 92nd St
Ste 101
Scottsdale, AZ 85258
Phone (480) 860-1919

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1831817477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 N 92ND ST STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584553",
            "telephone_number": "480-747-6532",
            "fax_number": "480-889-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 N 92ND ST STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584553",
            "telephone_number": "480-747-6532",
            "fax_number": "480-889-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVENSKI",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "279094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.