MRS. KYLA LEE MASSIMB (FNP-BC) – Family Nurse Practitioner, NPI 1548013360

MRS. KYLA LEE MASSIMB (FNP-BC) is a healthcare provider. based in Belvidere, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-BC. They hold a License No. 209.029912 (IL). The NPI Number for MRS. KYLA LEE MASSIMB (FNP-BC) is 1548013360

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KYLA LEE MASSIMB (FNP-BC)
NPI
1548013360
Phone
(815) 482-6365
Address
1004 Logan Ave
Enumeration Date
10 April 2024
Last Update Date
26 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8154826365
Graduation Year
2023 (3 years ago)
PAC ID
9537695291
Group Practice PAC ID
8729434279
Professional Enrollment ID
I20250102001511
Address ID
IL610083955BE1004XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MRS. KYLA LEE MASSIMB (FNP-BC)

  • 1004 Logan Ave

    Belvidere, IL 610083955

    Phone: (815) 482-6365

    Fax: (815) 604-8076

    Type: Location

  • 85 WOODBURY ST

    SOUTH ELGIN, IL 601771327

    Phone: (224) 238-8252

    Fax: (815) 604-8076

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $23.

Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.

Last reported payment date: 2024-09-23 • Largest payer in this snapshot: Avanos Medical ($23).

Total Amount

$23

General + Research + Ownership

Payments

1

Total payment records

General Amount

$23

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Avanos Medical$23
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: 2025-01-02

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
I20250102001511INurse PractitionerILTBD

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 61008)

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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: 8729434279View full group profile
NameSpecialtyState
Nurse PractitionerIL

Reviews

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Frequently asked questions

Is MRS. KYLA LEE MASSIMB (FNP-BC) listed with a National Provider Identifier?
Yes — MRS. KYLA LEE MASSIMB (FNP-BC) has NPI 1548013360 on file in the registry.
Would MRS. KYLA LEE MASSIMB (FNP-BC) appear as active to a payer?
You can treat MRS. KYLA LEE MASSIMB (FNP-BC) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with MRS. KYLA LEE MASSIMB (FNP-BC)?
MRS. KYLA LEE MASSIMB (FNP-BC)'s record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with MRS. KYLA LEE MASSIMB (FNP-BC)?
Directory geography for MRS. KYLA LEE MASSIMB (FNP-BC) centers on Belvidere, Illinois.
Can I trust this NPI listing for MRS. KYLA LEE MASSIMB (FNP-BC)?
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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