Kimberly Gerin, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

014978 Issued in NY

Practice address

353 Veterans Memorial Hwy
Commack, NY 11725-4200

Phone

(631) 543-4888

NPI assigned

Sep 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Goodman Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.gerin.1@12622.direct.athenahealth.com
• Direct secure messaging: kimberly.gerin.1@7628.direct.athenahealth.com

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.

• New York Dermatology & Mohs Surgery Group, PLLC

  • Dermatology Physician
  • Commack, NY
  • NPI 1851555122
  Medicare reassignment NPD
• Laserderm Dermatology & Cosmetic Laser Surgery

  • Dermatopathology Physician
  • Smithtown, NY
  • NPI 1942150131
  NPD (past)
• Manhattan Dermatology and Cosmetics PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1639495732
  NPD (past)

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1184907503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200",
            "telephone_number": "631-543-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERIN",
        "first_name": "KIMBERLY",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GOODMAN",
            "credential": "RPA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kerri Geoghegan
• Elana Marie Georgalas, SLP-CCC
• Nicole Alexis Georgiev, RD
• Michelle Gerardi, MS
• Adria M Gerber, PSY.D.
• Jennifer Geringer, LCSW
• Susan J German, RPH
• William J Germano, DC
• Nicholas Germinario, CASAC-T
• Catherine Corina Violet Gerontis, M.D.

• Physician Assistant in Commack, NY
• Providers in Commack, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.