Kimberly Ann Goldup, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Cohoes, NY
NPI 1861959686 · NPPES record last updated Feb 28, 2019
Key facts
- NPI
- 1861959686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F344010-1 (NY)
- Practice address
- 1 Arlington Rd
Cohoes, NY 12047-4001 - Phone
- (518) 764-2511
- NPI assigned
- Feb 28, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230605000867 | NY | Practitioner - Nurse Practitioner | 7810303138 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F344010-1 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rensselaer County Bureau of Finance | Current |
Accepting new patients | |
| Statline Medical PC | Current |
Accepting new patients | |
| Rensselaer County Bureau of Finance | Current |
Accepting new patients | |
| Rensselaer County Bureau of Finance | Past | Accepting new patients |
Locations
451 Broad St
Salamanca, NY 14779
Phone (716) 945-1800
85 Bloomingrove Dr
Troy, NY 12180
Phone (212) 851-8100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F344010-1 | NY | Yes |
Addresses
Primary practice location
1 Arlington Rd
Cohoes, NY 12047-4001
Mailing address
1 Arlington Rd
Cohoes, NY 12047-4001
Other providers in Cohoes, NY
- Joyce Elizabeth Gebele
- Jennifer Gillin
- Susannah S Gleeson
- Glens Falls Ambulance Service
- Meagan Golden
- Isaiah Gonsalves
- Joely Marie Graber
- Cailyn Florence Green
- Heather Green
- Erica Grim
All providers in Cohoes, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.