Mark Kimborowicz, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

35.047626 Issued in OH

Practice address

7350 Industrial Park Blvd
Mentor, OH 44060-5318

Phone

(216) 732-9480

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emergency Professional Services, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Middleburg Heights, OH
  • NPI 1932386059
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1497700397
  NPD
• Vpa PC

  • Family Medicine Physician
  • Middleburg Heights, OH
  • NPI 1821101809

  General Practice

  NPD
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362

  General Practice

  NPD
• Oscar Nicholson Jr MD Inc

  • Surgery Physician
  • Cleveland Heights, OH
  • NPI 1144491200
  NPD (past)
• Acute Care Specialists, Inc.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1447294640
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083655641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 INDUSTRIAL PARK BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605318",
            "telephone_number": "216-732-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 INDUSTRIAL PARK BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605318",
            "telephone_number": "216-732-9480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1995 E State St",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OH",
            "postal_code": "444602423",
            "country_code": "US",
            "telephone_number": "330-332-1551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1995 E State St",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OH",
            "postal_code": "444602423",
            "country_code": "US",
            "telephone_number": "330-332-1551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBOROWICZ",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35047626K",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35.047626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR-GA",
            "identifier": "930000109",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0493201",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "942460636194",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zamir Khan
• Sayed S Khatami, M.D.
• Elias Beshara Khawam, DMD
• Susan Meehae Kim, D.C.
• Jan S Kimball, LPCC
• Maria Kinford
• Ashlee King, LISW
• Jamika Yvonne King
• Jean Marie King, LISW-S
• Natalie Ruth King, RN

• General Practice Physician in Mentor, OH
• Providers in Mentor, OH by specialty
• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.