Individual provider Active NPI

Kimberly Bubnash, FNP-C

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1205391877
Registry record updated May 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R186900 Issued in MD
Practice address
2411 W Belvedere Ave Ste 205
Baltimore, MD 21215-5229
Phone
(410) 601-8331
NPI assigned
Feb 7, 2019
Last updated
May 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2019

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 R186900 MD Primary

Addresses

Primary practice location

2411 W Belvedere Ave Ste 205
Baltimore, MD 21215-5229

Mailing address

10794 Hickory Ridge Rd
Columbia, MD 21044-3646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190826000022 MD Practitioner - Nurse Practitioner 3072841386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

2118 Greenspring Dr
Timonium, MD 21093-3112
Phone (410) 560-3480

3333 N Calvert St
Baltimore, MD 21218-6502

412 Malcolm Dr
Suite 200
Westminster, MD 21157-6174
Phone (410) 751-8800

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Dec 10, 2019 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

3333 N Calvert St
Ste 400
Baltimore, MD 21218
Phone (410) 554-2270

12 Medstar Blvd
Ste 300
Bel Air, MD 21015
Phone (410) 296-6232

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

412 Malcolm Dr
Ste 200
Westminster, MD 21157
Phone (410) 751-7930

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557014400000",
    "number": "1205391877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10794 HICKORY RIDGE RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 W BELVEDERE AVE STE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155229",
            "telephone_number": "410-601-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBNASH",
        "first_name": "KIMBERLY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R186900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.