Individual provider Active NPI

Kristina Lyn Donbroski, AGACNP-BC

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1881278638
Registry record updated Jun 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
256761 Issued in AZ
Practice address
2610 N 3Rd St
Phoenix, AZ 85004-1102
Phone
(480) 610-6101
NPI assigned
May 7, 2021
Last updated
Jun 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2021

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 256761 AZ Primary

Addresses

Primary practice location

2610 N 3Rd St
Phoenix, AZ 85004-1102

Mailing address

14671 W Mountain View Blvd Ste 112
Surprise, AZ 85374-4840
Phone (480) 610-6100

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
I20210623003637 AZ Practitioner - Nurse Practitioner 9537560818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Kidney Institute PLCGroup PAC ID 8224930987, 100 clinicians

Practice addresses (Care Compare)

14671 W Mountain View Blvd
Suite 112
Surprise, AZ 85374-4840
Phone (480) 610-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.02 of 100Reported as group
Quality
69.14
Promoting interoperability
100
Improvement activities
40
Cost
77.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256761AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Kidney Institute, PLC CurrentSince May 6, 2021 Accepting new patients
Southwest Kidney Institute, PLC CurrentSince May 6, 2021 Accepting new patients

Locations

2610 N 3rd St
Phoenix, AZ 85004
Phone (602) 264-3541

9305 W Thomas Rd
Ste 255
Phoenix, AZ 85037
Phone (623) 247-9235

13041 N Del Webb Blvd
Ste 140
Sun City, AZ 85351

14671 W Mountain View Blvd
Ste 112
Surprise, AZ 85374

2149 E Warner Rd
Ste 101
Tempe, AZ 85284
Phone (480) 610-6111

2149 E Warner Rd
Ste 102
Tempe, AZ 85284
Phone (623) 247-0808

1845 W Orange Grove Rd
Ste 111
Tucson, AZ 85704
Phone (520) 329-8298

905 N Bowie Ave
Willcox, AZ 85643
Phone (520) 326-4811

Interoperability endpoints

  • Direct secure messaging: kristina.donbroski.1@2697.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624665600000",
    "number": "1881278638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14671 W MOUNTAIN VIEW BLVD STE 112",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744840",
            "telephone_number": "480-610-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041102",
            "telephone_number": "480-610-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONBROSKI",
        "first_name": "KRISTINA",
        "middle_name": "LYN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "256761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.