Individual provider Active NPI

Kimberly Chin

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1124364278
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2265455 Issued in MA
Practice address
125 Parker Hill Ave
Boston, MA 02120-2847
Phone
(617) 754-5474
Fax
(617) 754-5473
NPI assigned
Dec 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2265455 MA Primary

Addresses

Primary practice location

125 Parker Hill Ave
Boston, MA 02120-2847

Mailing address

125 Parker Hill Ave
Boston, MA 02120-2847

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20130408000413 MA Practitioner - Nurse Practitioner 9335384726 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
Group practices
Carl T Talmo MD PCGroup PAC ID 7315022332, 2 clinicians

Practice addresses (Care Compare)

125 Parker Hill Ave
Suite 580
Boston, MA 02120-2847
Phone (617) 754-5474

Hospital & facility affiliations

  • New England Baptist Hospital Hospital, Boston, MA, CCN 220088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2265455MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carl T Talmo MD PC CurrentSince Jan 27, 2013 Accepting new patients

Locations

125 Parker Hill Ave
Ste 580
Roxbury Xing, MA 02120
Phone (617) 264-4848

125 Parker Hill Ave
Roxbury Xing, MA 02120
Phone (617) 264-1100

Interoperability endpoints

  • Direct secure messaging: kchin252894@direct.bilh.masshiway.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/FGGDAA/Endpoint/FGGDAA

Organizations & group practices 1

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 1

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": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1124364278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021202847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021202847",
            "telephone_number": "617-754-5474",
            "fax_number": "617-754-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2265455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.