Kimberly Ciaccia

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

382611 Issued in NY

Practice address

10101 Rockaway Blvd
Ozone Park, NY 11417-2228

Phone

(917) 566-9440

NPI assigned

Jul 7, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: kimberlyciaccia@nslijmedgr.allscriptsdirect.net

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1861875080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 ROCKAWAY BLVD",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114172228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 ROCKAWAY BLVD",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114172228",
            "telephone_number": "917-566-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIACCIA",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "687399",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kashif M Choudhry, P.A
• Sharmin Choudhury, PA
• Tanzina Choudhury, PHARMD
• Nazir Ahmmed Chowdhury
• Maxine Christie
• Citidental of Woodhaven PC
• City Medical of Upper East Side, PLLC
• Alysia Clarke, LMSW
• Suraya Jabin Clemente, M.S.ED, LMHC, CRC
• Code and App Inc

• Pediatric Nurse Practitioner in Ozone Park, NY
• Providers in Ozone Park, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.