NPIMap

Individual provider Active NPI

Kimberly Ann Tobin, CRNP

  • Adult Health Nurse Practitioner
  • Collegeville, PA
National Provider Identifier
1104192699
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP011916 Issued in PA
Practice address
611 Gravel Pike
Collegeville, PA 19426-1600
Phone
(610) 489-4151
NPI assigned
Mar 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP011916 PA Primary

Addresses

Primary practice location

611 Gravel Pike
Collegeville, PA 19426-1600

Mailing address

230 N 7TH Ave
Royersford, PA 19468-2114
Phone (610) 513-8090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131017000794 PA Practitioner - Nurse Practitioner 2365676764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Pottstown Clinic Company LLCGroup PAC ID 6406857184, 112 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

730 S Hanover St
Pottstown, PA 19465-7520
Phone (610) 323-6835

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.7 of 100Reported as group
Quality
76.12
Promoting interoperability
99
Improvement activities
40
Cost
73.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pottstown Clinic Company LLC CurrentSince Jul 23, 2013 Accepting new patients
Pottstown Hospital Company LLC Past Accepting new patients

Locations

730 S Hanover St
Pottstown, PA 19465
Phone (610) 323-6835

Organizations & group practices 2

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.

Hospital & facility affiliations 12

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1104192699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N 7TH AVE",
            "city": "ROYERSFORD",
            "state": "PA",
            "postal_code": "194682114",
            "telephone_number": "610-513-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 GRAVEL PIKE",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194261600",
            "telephone_number": "610-489-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP011916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegeville, PA

Sources for this page

Verify at the official NPI Registry.