Samuel M. Kippenberger, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

055.0031092 Issued in VT

Practice address

25 Ridgewood Rd
Esne/Springfield Hospital Emergency Department
Springfield, VT 05156-3050

Phone

(802) 885-7540

NPI assigned

Feb 17, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Catholic Medical Center Hospital, Manchester, NH, CCN 300034

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.kippenberger@hca6.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  NH

  Medicare reassignment Care Compare group
• Catholic Medical Center

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1427154335
  Medicare reassignment NPD
• Catholic Medical Center

  • Anesthesiology Physician
  • Manchester, NH
  • NPI 1003692112
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Manchester Health Services, LLC

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1972340990
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1003138181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 RIDGEWOOD RD",
            "address_2": "ESNE/SPRINGFIELD HOSPITAL EMERGENCY DEPARTMENT",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051563050",
            "telephone_number": "802-885-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 RIDGEWOOD RD",
            "address_2": "ESNE/SPRINGFIELD HOSPITAL EMERGENCY DEPARTMENT",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051563050",
            "telephone_number": "802-885-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPPENBERGER",
        "first_name": "SAMUEL",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30337990",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000464",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Kelly, L.P.C., PH.D.
• Jill A. King, BA RN
• Kayla King
• Margaret Packard King, CCC-SLP
• Nichole Kingsbury, ASSOC. HUMAN SERVICE
• Caroline Kirkpatrick
• Heather M Koledo, LMFT
• Lindsay Korsen, BA
• KPH Healthcare Services Inc
• Irene Barbara Krechetoff, D.O.

• Physician Assistant in Springfield, VT
• Providers in Springfield, VT by specialty
• Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.