NPIMap

Individual provider Active NPI

Samuel W Kimani, MD

  • Pulmonary Disease Physician
  • Bloomington, IN
National Provider Identifier
1053576496
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01081868A Issued in IN
Practice address
550 S Landmark Ave
Bloomington, IN 47403
Phone
(812) 331-3400
Fax
(812) 332-7265
NPI assigned
Jul 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2014-02169 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2014-02169 NC
Pulmonary Disease Physician 207RP1001X 2014-02169 NC
Pulmonary Disease Physician 207RP1001X 01081868A IN Primary

Addresses

Primary practice location

550 S Landmark Ave
Bloomington, IN 47403

Mailing address

3943 E Fenbrook LN
Bloomington, IN 47401-7739
Phone (812) 345-8890

Other practice location 1

1001 W 10th St
west bldg M200
Indianapolis, IN 46202-2859
Phone (317) 656-4260

Other practice location 2

11104 Parkview Circle Dr Ste 410
Fort Wayne, IN 46845-0025
Phone (260) 266-7856

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address skimani512964@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MO, KY, KS4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20190411002547 IN Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8628203882 Reassigns benefits to 3 organizations
I20221215000809 MO Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8628203882 Reassigns benefits to 1 organization
I20240222003685 KY Practitioner - Internal Medicine 8628203882 Reassigns benefits to 2 organizations
I20260228000931 KS Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8628203882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians
Vigilias LLCGroup PAC ID 9133433279, 49 clinicians
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Mercy Clinic Joplin Intensivists
Joplin, MO 64804-4524
Phone (417) 556-2330

11104 Parkview Plaza Dr
410 PPG Pulmonary and Critical Care
Fort Wayne, IN 46845-1730
Phone (260) 266-7856

425 N Belmont Ave
Wichita, KS 67208-3810
Phone 3165007549700

519 Harriet St
Evansville, IN 47710-1715
Phone (812) 450-7720

546 Lone Oak Rd
Paducah, KY 42003-4526
Phone (270) 442-3647

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2014-02169NCMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Critical Care Medicine CurrentSince Nov 1, 2024 Accepting new patients
Parkview Health System, Inc. Internal Medicine CurrentSince Nov 25, 2022 Accepting new patients
Deaconess Hospital, Inc Internal Medicine Current Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
Deaconess Hospital Inc CurrentSince Nov 1, 2024 Accepting new patients
Vigilias LLC Internal Medicine CurrentSince Feb 1, 2026 Accepting new patients
Mercy Clinic Joplin LLC Internal Medicine CurrentSince Dec 21, 2022 Accepting new patients
Parkview Health System Inc Internal Medicine Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Feb 1, 2026 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Feb 1, 2026 Accepting new patients
Indiana University Health Care Associates, Inc Past Accepting new patients
Baptist Health Medical Group Inc Internal Medicine Past Accepting new patients
Mercy Hospital Joplin Past Accepting new patients

Locations

519 Harriet St
Evansville, IN 47710
Phone (812) 423-9699

4600 W Lloyd Expy
Evansville, IN 47712
Phone (812) 450-6311

11104 Parkview Circle Dr
Ste 410
Fort Wayne, IN 46845
Phone (260) 266-5260

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

4015 Gateway Blvd
#2121
Newburgh, IN 47630
Phone (812) 450-7720

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

546 Lone Oak Rd
Paducah, KY 42003
Phone (270) 441-4777

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

Interoperability endpoints

  • Direct secure messaging: skimani660476@direct.deaconess.com
  • Direct secure messaging: skimani512964@direct.parkviewexchange.com

Organizations & group practices 14

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

View all 14

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1053576496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3943 E FENBROOK LN",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474017739",
            "telephone_number": "812-345-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "47403",
            "telephone_number": "812-331-3400",
            "fax_number": "812-332-7265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 W 10th St",
            "address_2": "west bldg M200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462022859",
            "country_code": "US",
            "telephone_number": "317-656-4260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11104 Parkview Circle Dr Ste 410",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468450025",
            "country_code": "US",
            "telephone_number": "260-266-7856",
            "fax_number": "260-266-5279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMANI",
        "first_name": "SAMUEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2014-02169",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2014-02169",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "2014-02169",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01081868A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skimani512964@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 410",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468450025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 410",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468450025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11104 Parkview Circle Dr Ste 410",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468450025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.