Kim H Dedeus, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0504P Issued in NH

Practice address

333 Borthwick Ave
Medical Office Building Suite 301
Portsmouth, NH 03801-7128

Phone

(603) 431-5858

Fax

(603) 431-5818

NPI assigned

Sep 23, 2005

Last updated

Feb 16, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Knee Hip and Shoulder CenterGroup PAC ID 7911976998, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

65.34 of 100Reported as group

Quality

40.92

Improvement activities

40

Cost

63.24

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• The Knee Hip & Shoulder Center

  • Orthopaedic Surgery Physician
  • Portsmouth, NH
  • NPI 1053326868
  Medicare reassignment Care Compare group
• Jeffries Family Medicine, PLLC

  • Family Medicine Physician
  • Manchester, NH
  • NPI 1720049240
  NPD (past)
• Pace Inc.

  • Exclusive Provider Organization
  • Portsmouth, NH
  • NPI 1780183053
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1063408144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVE",
            "address_2": "MEDICAL OFFICE BUILDING SUITE 301",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017128",
            "telephone_number": "603-431-5858",
            "fax_number": "603-431-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVE",
            "address_2": "MEDICAL OFFICE BUILDING SUITE 301",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017128",
            "telephone_number": "603-431-5858",
            "fax_number": "603-431-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDEUS",
        "first_name": "KIM",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0504P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret M. Dawson, ED.D
• Heather Day
• Daniel H De Tolla, D.D.S., M.D.
• Ramsay Dean, LICSW
• Christina Debourgknecht
• Juliana Defeo
• Peter Joseph Degnan, MD
• Jenessa Deleault, PSY.D.
• Rossli Chace Delorey, FNP-C
• Makaela Delucca, CRNA

• Surgical Physician Assistant in Portsmouth, NH
• Providers in Portsmouth, NH by specialty
• Surgical Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.