Individual provider Active NPI

Kylie B Di Lulo, NP-C

  • Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1932741212
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
63080 Issued in ID
Practice address
655 Montgomery St Ste 810
San Francisco, CA 94111-2677
Phone
(844) 847-8216
Fax
(415) 520-9150
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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 63080 ID Primary

Addresses

Primary practice location

655 Montgomery St Ste 810
San Francisco, CA 94111-2677

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

1309 E Fall Ct
Boise, ID 83706-5076
Phone (208) 866-0001

Other practice location 2

703 S Americana Blvd Ste 130
Boise, ID 83702-6754
Phone (208) 706-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20200303001038 ID Practitioner - Nurse Practitioner 6305273319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10723CTMDPharmacist
9692MNMDPhysician Assistant
63080IDMDNurse Practitioner
350280NYMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ready Responders Pennsylvania LLC PastSince Aug 1, 2024 Accepting new patients
Major Hospital Past Accepting new patients
Healthtap Medical Group, P.C. PastSince Feb 1, 2022 Accepting new patients

Organizations & group practices 4

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": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1932741212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 MONTGOMERY ST STE 810",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941112677",
            "telephone_number": "844-847-8216",
            "fax_number": "415-520-9150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1309 E Fall Ct",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837065076",
            "country_code": "US",
            "telephone_number": "208-866-0001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 S Americana Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026754",
            "country_code": "US",
            "telephone_number": "208-706-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DI LULO",
        "first_name": "KYLIE",
        "middle_name": "B",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "63080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.