Individual provider Active NPI

Kimberly Ann Pinckney, P.A.

  • Medical Physician Assistant
  • Fountain Valley, CA
National Provider Identifier
1134328941
Registry record updated Aug 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 18662 Issued in CA
Practice address
18255 Brookhurst St Ste 100
Fountain Valley, CA 92708-6771
Phone
(657) 241-3600
Fax
(657) 241-7708
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 18662 CA Primary

Addresses

Primary practice location

18255 Brookhurst St Ste 100
Fountain Valley, CA 92708-6771

Mailing address

PO Box 3699
Newport Beach, CA 92659-8699
Phone (714) 378-5330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20141029002786 CA Practitioner - Physician Assistant 3375764624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

1031 Avenida Pico
Suite 204
San Clemente, CA 92673-6352
Phone (949) 829-5533

500 Superior Ave
Suite 270
Newport Beach, CA 92663-3657
Phone (949) 791-3370

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
84.12
Promoting interoperability
100
Improvement activities
40
Cost
74.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
18662CAMDNeurology Physician
PA 18662CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Digestive Care Inc Past Accepting new patients
Hoag Hospital Past Accepting new patients

Organizations & group practices 3

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407542400000",
    "number": "1134328941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3699",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926598699",
            "telephone_number": "714-378-5330",
            "fax_number": "714-378-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18255 BROOKHURST ST STE 100",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086771",
            "telephone_number": "657-241-3600",
            "fax_number": "657-241-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINCKNEY",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2014-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 18662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.