ANDRINA KALITA (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1235023664

ANDRINA KALITA (PMHNP) is a healthcare provider. based in Idaho falls, Idaho. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 4371464 (ID). The NPI Number for ANDRINA KALITA (PMHNP) is 1235023664

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
ANDRINA KALITA (PMHNP)
NPI
1235023664
Phone
(208) 524-7400
Address
2265 W BROADWAY ST
Enumeration Date
9 June 2025
Last Update Date
29 January 2026

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
2085247400
Graduation Year
2025 (1 year ago)
PAC ID
4789175894
Group Practice PAC ID
0547585895
Professional Enrollment ID
I20251117003607
Address ID
ID834022902ID2275XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

1,802 NURSE PRACTITIONER in ID

Provider Addresses for ANDRINA KALITA (PMHNP)

  • 2265 W BROADWAY ST

    IDAHO FALLS, ID 834022996

    Phone: (208) 524-7400

    Fax: (208) 542-8004

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-11-17

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
I20251117003607INurse PractitionerIDTBD

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 83402)

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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: 0547585895View full group profile
NameSpecialtyState
Mental Health CounselorID
Mental Health CounselorID
P S Y C H I A T R YID
-ID
Clinical Social WorkerID
Mental Health CounselorID
Clinical Social WorkerID
Clinical Social WorkerID
Clinical Social WorkerID
-UT

Reviews

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Frequently asked questions

Is ANDRINA KALITA (PMHNP) listed with a National Provider Identifier?
Yes — ANDRINA KALITA (PMHNP) has NPI 1235023664 on file in the registry.
Is ANDRINA KALITA (PMHNP) shown as active in public data?
Registry records indicate ANDRINA KALITA (PMHNP) maintains an active NPI.
What clinical focus is listed for ANDRINA KALITA (PMHNP)?
At a glance, ANDRINA KALITA (PMHNP) is tied to Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Idaho is ANDRINA KALITA (PMHNP) registered?
Use Idaho Falls, Idaho as the headline location for ANDRINA KALITA (PMHNP) here.
Can I trust this NPI listing for ANDRINA KALITA (PMHNP)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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