Individual provider Active NPI

Kelsey Kimball, PA-C

  • Physician Assistant
  • Gainesville, FL
National Provider Identifier
1164024253
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113627 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 273-7002
Fax
(352) 273-7388
NPI assigned
Nov 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113627 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

PO Box 112727
Gainesville, FL 32611-2727
Phone (352) 273-7002

Other practice location 1

4500 W Newberry Rd
Gainesville, FL 32607
Phone (352) 336-6000

Other practice location 2

3450 Hull Rd
Gainesville, FL 32607-4144
Phone (352) 273-7001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20201204001197 FL Practitioner - Physician Assistant 7214348754 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Clinical Practice Association IncGroup PAC ID 0345146254, 1,886 clinicians

Practice addresses (Care Compare)

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

3450 Hull Rd
Gainesville, FL 32607-4144

3450 SW Hull Rd
Uf Health Pediatric Urology Osmi
Gainesville, FL 32607-4144
Phone (352) 265-8240

3480 Hull Rd
Gainesville, FL 32607-4144
Phone (352) 338-7100

Hospital & facility affiliations

  • Uf Health Shands Hospital Hospital, Gainesville, FL, CCN 100113

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9113627FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 11, 2023 Accepting new patients
The Orthopaedic Institute, PA CurrentSince Oct 25, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 11, 2023 Accepting new patients
The Orthopaedic Institute PA CurrentSince Oct 25, 2020 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

3450 Hull Rd
Gainesville, FL 32607
Phone (352) 273-7002

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

146 SW Orthopedic Ct
Lake City, FL 32024
Phone (386) 755-9215

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kkimball248815@direct.shands.ufl.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1164024253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 112727",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326112727",
            "telephone_number": "352-273-7002",
            "fax_number": "352-273-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-7002",
            "fax_number": "352-273-7388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 W Newberry Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "32607",
            "country_code": "US",
            "telephone_number": "352-336-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3450 Hull Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326074144",
            "country_code": "US",
            "telephone_number": "352-273-7001",
            "fax_number": "352-273-7388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "KELSEY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-12",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.