Individual provider Active NPI

Kimberly A Monnin, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
National Provider Identifier
1114947603
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
L7817 Issued in TX
Practice address
9200 Wall St
Austin, TX 78754-4534
Phone
(512) 375-1275
Fax
(512) 873-5004
NPI assigned
Jul 20, 2006
Last updated
May 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A83665 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X L7817 TX Primary

Addresses

Primary practice location

9200 Wall St
Austin, TX 78754-4534

Mailing address

9200 Wall St
Austin, TX 78754-4534
Phone (512) 375-1275

Other identifiers 2

IdentifierTypeStateIssuer
00A836650MedicaidCA
311355701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20120914000492 TX Practitioner - Pathology 0244291284 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A83665CAMDSpecialist
A83865CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hurt, Jacknow, Moore, Connor, Wells, Michels, Yurco, Listrom & Huang Anatomic Pathology & Clinical Pathology CurrentSince Sep 17, 2012 Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Oct 1, 2024 Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Oct 1, 2024 Accepting new patients
Diagnostic Pathology Medical Group Inc Specialist Past Accepting new patients

Locations

3445 Executive Center Dr
Ste 250
Austin, TX 78731
Phone (512) 339-1275

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

9200 Wall St
Austin, TX 78754
Phone (512) 339-1275

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

3131 University Dr E
Bryan, TX 77802
Phone (979) 680-1888

1101 Woodson Dr
Caldwell, TX 77836
Phone (409) 567-3245

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

100 W Cross St
Madisonville, TX 77864
Phone (409) 348-2631

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1114947603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 WALL ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787544534",
            "telephone_number": "512-375-1275",
            "fax_number": "512-873-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 WALL ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787544534",
            "telephone_number": "512-375-1275",
            "fax_number": "512-873-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONNIN",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A83665",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "L7817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A836650",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311355701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.