KIMBERLY BROOKE DELANDTSHEER – Family Nurse Practitioner, NPI 1124711247

KIMBERLY BROOKE DELANDTSHEER is a healthcare provider. based in Big bear lake, California. specializing in NURSE PRACTITIONER. They hold a License No. 95024727 (CA). The NPI Number for KIMBERLY BROOKE DELANDTSHEER is 1124711247

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY BROOKE DELANDTSHEER
NPI
1124711247
Phone
(909) 878-8000
Address
PO BOX 6918
Enumeration Date
2 June 2023
Last Update Date
2 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9098788000
Graduation Year
2022 (4 years ago)
PAC ID
8527581040
Group Practice PAC ID
5092185546
Professional Enrollment ID
I20250325003868
Address ID
CA923152190BI42002RDXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for KIMBERLY BROOKE DELANDTSHEER

  • PO BOX 6918

    BIG BEAR LAKE, CA 923156918

    Phone: (909) 878-8000

    Type: Mailing

  • 42002 FOX FARM RD

    BIG BEAR LAKE, CA 923152190

    Phone: (909) 878-8000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $121.

Total Amount is formed as General ($121) + Research ($0) + Ownership ($0) = $121.

Last reported payment date: 2024-07-30 • Largest payer in this snapshot: Amgen Inc. ($44).

Total Amount

$121

General + Research + Ownership

Payments

6

Total payment records

General Amount

$121

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250325003868INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92315)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092185546View full group profile
NameSpecialtyState
Physician AssistantCA
Internal MedicineCA
O P T O M E T R YCA
Family PracticeCA
Internal MedicineHI
Physician AssistantCA
Physician AssistantCA
Nurse PractitionerCA
Family PracticeCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What NPI should I save for KIMBERLY BROOKE DELANDTSHEER?
Save NPI 1124711247 if you need a stable reference for KIMBERLY BROOKE DELANDTSHEER.
Is KIMBERLY BROOKE DELANDTSHEER's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does KIMBERLY BROOKE DELANDTSHEER list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for KIMBERLY BROOKE DELANDTSHEER. Clinical services aligned with this taxonomy classification.
What location shows for KIMBERLY BROOKE DELANDTSHEER?
We surface Big Bear Lake, California for KIMBERLY BROOKE DELANDTSHEER based on available NPPES addresses.
How can I contact KIMBERLY BROOKE DELANDTSHEER?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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