KIMBERLEY R FANTASIA (FNP) – Family Nurse Practitioner, NPI 1154547479

KIMBERLEY R FANTASIA (FNP) is a healthcare provider. based in Waterville, Maine. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. R051730 (ME). The NPI Number for KIMBERLEY R FANTASIA (FNP) is 1154547479

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLEY R FANTASIA (FNP)
NPI
1154547479
Phone
(207) 681-3000
Address
200 KENNEDY MEMORIAL DR
Enumeration Date
17 April 2007
Last Update Date
2 September 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8135018201
Graduation Year
2007 (19 years ago)
PAC ID
5496856379
Group Practice PAC ID
3678611837
Professional Enrollment ID
I20170412002214
Address ID
FL346535240NE6117XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:19State licenses:2Digital endpointsOther names

1,869 NURSE PRACTITIONER in ME

Provider Addresses for KIMBERLEY R FANTASIA (FNP)

  • 200 KENNEDY MEMORIAL DR

    WATERVILLE, ME 049014526

    Phone: (207) 681-3000

    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: 2017-04-12

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
I20170412002214INurse PractitionerFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes3514$0
99214Established patient office or other outpatient visit, 30-39 minutes3015$0
View full utilization report →

Insurance plans in this area (ZIP 04901)

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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: 3678611837View full group profile
NameSpecialtyState
Nurse PractitionerTN
Nurse PractitionerFL
Nurse PractitionerFL
Family PracticeFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Physician AssistantFL

Reviews

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Frequently asked questions

Does KIMBERLEY R FANTASIA (FNP) have a public NPI I can cite?
Public records show KIMBERLEY R FANTASIA (FNP) under NPI 1154547479.
Should I treat KIMBERLEY R FANTASIA (FNP) as an active provider?
Patients and plans typically see KIMBERLEY R FANTASIA (FNP) as active in the national extract.
How should patients interpret KIMBERLEY R FANTASIA (FNP)'s specialty?
The extract shows Family Nurse Practitioner for KIMBERLEY R FANTASIA (FNP). Clinical services aligned with this taxonomy classification.
Is KIMBERLEY R FANTASIA (FNP) tied to Waterville, Maine?
If you are local to Waterville, Maine, KIMBERLEY R FANTASIA (FNP) may be relevant to your search.
Can I export KIMBERLEY R FANTASIA (FNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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