Kimberly Ann Defatta, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F381894-1 Issued in NY

Practice address

8268 164TH St
Jamaica, NY 11432-1121

Phone

(718) 883-4500

NPI assigned

Jul 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kimberly Ann Defatta Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Networks

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

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1992903983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5631 226TH ST",
            "address_2": "APT 1",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8268 164TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321121",
            "telephone_number": "718-883-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFATTA",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381894-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DEFATTA",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "PNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Eileen S Debbi, MD
• Cristina R Decena
• Vincent J Decurtis, CRPA
• Aleesha Deen-Nandkisure
• Deepak S. Mahajan Physician P.C
• Pamela Defensor, DPT
• Celeste Maria Defillo-Lopez, MD
• Michelle Andrea Defreitas, L.C.S.W
• Jennifer Dei
• April Shawn Dejesus, LMHC

• Pediatric Nurse Practitioner in Jamaica, NY
• Providers in Jamaica, 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 11, 2007; 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.