Kimberly Demetriou Walker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

007892 Issued in CO

Practice address

11990 Grant St Ste 400
Northglenn, CO 80233-1136

Phone

(720) 749-5599

Fax

(720) 925-5897

NPI assigned

Aug 29, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, CO2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain View Pain SpecialistsGroup PAC ID 7911255013, 53 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

30.58 of 100Reported as group

Quality

9.59

Promoting interoperability

0

Improvement activities

0

Cost

68.57

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.walker@3675.securemail.prognocis.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.

• Mountain View Pain Specialists

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Lone Tree, CO
  • NPI 1912403544
  Medicare reassignment Care Compare group NPD
• Gwinnett Emergency Specialists Observation Services, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1720373129
  Medicare reassignment
• Gwinnett Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1437346467
  Medicare reassignment
• Northside Emergency Associates, LLC

  • Emergency Medicine Physician
  • Sandy Springs, GA
  • NPI 1285686303
  Medicare reassignment
• Me Physical Therapy LLC

  • Physical Therapist
  • Aurora, CO
  • NPI 1154797157
  NPD (past)

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1013266675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 DTC PKWY STE 1130",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113038",
            "telephone_number": "720-749-5599",
            "fax_number": "720-925-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 GRANT ST STE 400",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802331136",
            "telephone_number": "720-749-5599",
            "fax_number": "720-925-5897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Medical Center Blvd",
            "address_2": "500 Building, Suite 360",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467694",
            "country_code": "US",
            "telephone_number": "678-312-3318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KIMBERLY",
        "middle_name": "DEMETRIOU",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6556",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "6556",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "007892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasper Vue
• Lauren Michelle Wackowski, M.S., OTR/L
• Tonya Sue Waldschmidt, BA.
• Walgreen Co
• Walgreen Co.
• Leann Walker
• Walmart Inc.
• Nicholas Walsh
• Cynthia Wander, MA
• Wanderspring, LLC

• Physician Assistant in Northglenn, CO
• Providers in Northglenn, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.