Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Kimberly J Perdomo, AGPCNP-BC

Individual provider Internal Medicine Physician · NPI 1861068827

MS. Kimberly J Perdomo, AGPCNP-BC is a Nurse Practitioner in Hackensack, New Jersey. Qualified in 2020, 6 years ago. Practices with Practice Associates Medical Group, a 1,403-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
6
Licensed in
NJ
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

92 Summit Ave
Hackensack, NJ 07601-1263
Phone: (201) 342-0066
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 26NJ01163000 (NJ)
Internal Medicine Physician Taxonomy 207R00000X · Licence 26NJ01163000 (NJ)

Record details

NPI number1861068827
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGPCNP-BC
Sole proprietorYes
NPI enumeratedJune 1, 2021
Last updated in NPPESAugust 9, 2021
Certification dateAugust 9, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Practice Associates Medical Group — 1403 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Hackensack