Individual provider Active NPI

Kathryn Imbordino, APRN

  • Certified Registered Nurse Anesthetist
  • Stanford, CA
National Provider Identifier
1942773296
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95001513 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Jan 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN11000886 FL
Certified Registered Nurse Anesthetist 367500000X 95001513 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

3601 W Commercial Blvd Ste 5
Fort Lauderdale, FL 33309-3392
Phone (954) 485-5666

Other practice location 1

201 E Sample Rd
Pompano Beach, FL 33064-3502
Phone (708) 359-5607

Other identifiers 1

IdentifierTypeStateIssuer
102065100MedicaidFL

Other names 1

  • Kathryn Beyer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210414001611 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204174105 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

2452 Watson CT
Palo Alto, CA 94303-3216
Phone (650) 723-6995

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Hospital & facility affiliations

  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile CurrentSince Apr 1, 2021 Accepting new patients
Stanford Health Care CurrentSince Apr 1, 2021 Accepting new patients
Stanford Health Care Anesthesiology CurrentSince Apr 1, 2021 Accepting new patients

Locations

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

2425 Samaritan Dr
San Jose, CA 95124
Phone (408) 354-2114

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

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.

Hospital & facility affiliations 7

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": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1942773296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W COMMERCIAL BLVD STE 5",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093392",
            "telephone_number": "954-485-5666",
            "fax_number": "954-484-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Sample Rd",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330643502",
            "country_code": "US",
            "telephone_number": "708-359-5607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMBORDINO",
        "first_name": "KATHRYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11000886",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102065100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "BEYER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.