Individual provider Active NPI

Kim A Barra, RPA

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1164567103
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002167-1 Issued in NY
Practice address
911 Flatbush Ave
Room BS 14
Brooklyn, NY 11226-4017
Phone
(718) 564-2400
Fax
(718) 282-0789
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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 002167-1 NY Primary

Addresses

Primary practice location

911 Flatbush Ave
Room BS 14
Brooklyn, NY 11226-4017

Mailing address

911 Flatbush Ave
Room BS 14
Brooklyn, NY 11226-4017
Phone (718) 564-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260520002515 NY Practitioner - Physician Assistant 1850860743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

27 Barrow St
New York, NY 10014-3823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002167-1NYMDMedical Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1164567103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 FLATBUSH AVE",
            "address_2": "ROOM BS 14",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264017",
            "telephone_number": "718-564-2400",
            "fax_number": "718-282-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 FLATBUSH AVE",
            "address_2": "ROOM BS 14",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264017",
            "telephone_number": "718-564-2400",
            "fax_number": "718-282-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRA",
        "first_name": "KIM",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "RPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "002167-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.