Active NPI
Kimberly Louise Powell, PA-C
- Surgical Physician Assistant
- Detroit, MI
National Provider Identifier
1023336583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 004207
- Practice address
- 6071 W Outer Dr
Detroit, MI 48235-2624 - Phone
- (313) 966-6870
- NPI assigned
- May 8, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601005713 | MI | |
| Physician Assistant | 363A00000X | 50.003040 | OH | |
| Physician Assistant | 363A00000X | 25MP00236100 | NJ | |
| Physician Assistant | 363A00000X | 004207 | CT | |
| Medical Physician Assistant | 363AM0700X | 004207 | CT | |
| Surgical Physician Assistant | 363AS0400X | 004207 | CT | Primary |
Addresses
Primary practice location
6071 W Outer Dr
Detroit, MI 48235-2624
Mailing address
1382 Bishop Rd
Grosse Pointe Park, MI 48230-1146
Phone (508) 922-8064
Other names 1
- Kimberly Louise Hebeler
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
18101 Oakwood Blvd
Dearborn, MI 48124-4089
28100 Grand River Ave
Farmington Hills, MI 48336-5970
468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1705
Hospital & facility affiliations
- Beaumont Hospital - Grosse Pointe
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.003040 | OH | MD | Physician Assistant |
| 004207 | CT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Trauma Associates, P.C. | Past | Accepting new patients |
Interoperability endpoints
- kpowell1251529@epic00.shdirect.org
Organizations & group practices 3
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.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
-
- Diagnostic Radiology Physician
- Phoenix, AZ
- NPI 1376719666
MI
-
- Trauma Surgery Physician
- Neptune, NJ
- NPI 1023172236
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1811044878
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642377600000",
"number": "1023336583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1382 BISHOP RD",
"city": "GROSSE POINTE PARK",
"state": "MI",
"postal_code": "482301146",
"telephone_number": "508-922-8064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6071 W OUTER DR",
"city": "DETROIT",
"state": "MI",
"postal_code": "482352624",
"telephone_number": "313-966-6870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "KIMBERLY",
"middle_name": "LOUISE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-08",
"last_updated": "2022-01-17",
"certification_date": "2022-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601005713",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.003040",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00236100",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "004207",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CT",
"license": "004207",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CT",
"license": "004207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "HEBELER",
"middle_name": "LOUISE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.