Kimberly Anne Dewey, MD
Individual provider Active NPI Pediatric Adolescent Medicine Physician · Wilbraham, MA
NPI 1063408581 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1063408581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Adolescent Medicine Physician 2080A0000X
- License
- 220683 (MA)
- Practice address
- 2207 Boston Rd
Wilbraham, MA 01095-1155 - Phone
- (413) 599-1201
- Fax
- (413) 596-2940
- NPI assigned
- Sep 20, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 220683 | MA | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| George F Vitek MD & Associates PC | Adolescent Medicine | Past | Accepting new patients |
Interoperability endpoints
- kdewey14105@direct.chppoc.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 220683 | MA | Yes |
Addresses
Primary practice location
2207 Boston Rd
Wilbraham, MA 01095-1155
Mailing address
2207 Boston Rd
Wilbraham, MA 01095-1155
Phone (413) 599-1201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220683 | Other | MA LICENSE | |
| 2080303 | Medicaid | MA | |
| 7034605 | Other | AETNA/USHC | |
| 220683 | Other | CONNECTICARE | |
| AA16576 | Other | HARVARD PILGRIM | |
| 000000028542 | Other | BOSTON MED CENTER HEALTHN | |
| 1205530 | Other | UNITED HEALTHCARE | |
| 70513 | Other | CHILDRENS MEDICAL SECURIT | |
| 969421 | Other | NETWORK HEALTH | |
| J27969 | Other | BCBS | |
| 34817 | Other | HEALTH NEW ENGLAND |
Other providers in Wilbraham, MA
- Martha Yvette Davis
- Laura Ruth Dayton
- Drew Dearden
- Dermatology and Laser Center of Western Mass Inc
- Michael Raymond Devine
- Melanie Drobot
- Kimberly Duffany
- Peter John Duplessis
- Eagle Nest Home Health Care, LLC
- Caitlin Elizabeth Eckhoff
All providers in Wilbraham, MA · Pediatric Adolescent Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.