Active NPI
Kimberly Hogan Pesaniello, M.D.
- Psychiatry Physician
- Snow Hill, MD
National Provider Identifier
1235256900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D0041545
- Practice address
- 105 N Washington St
Snow Hill, MD 21863-1229 - Phone
- (757) 894-3118
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | D0041545 | MD | Primary |
Addresses
Primary practice location
105 N Washington St
Snow Hill, MD 21863-1229
Mailing address
105 N Washington St
Snow Hill, MD 21863-1229
Phone (757) 894-3118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111213000091 | VA | Practitioner - Psychiatry | 2769657287 | Practice locations: Chincoteague Island, VA |
| I20131126001362 | MD | Practitioner - Psychiatry | 2769657287 | Practice locations: Snow Hill, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Johns Hopkins University School of Medicine, 1989
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
105 N Washington St
Snow Hill, MD 21863-1229
Phone (757) 894-3118
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0041545 | MD | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476403200000",
"number": "1235256900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N WASHINGTON ST",
"city": "SNOW HILL",
"state": "MD",
"postal_code": "218631229",
"telephone_number": "757-894-3118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N WASHINGTON ST",
"city": "SNOW HILL",
"state": "MD",
"postal_code": "218631229",
"telephone_number": "757-894-3118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESANIELLO",
"first_name": "KIMBERLY",
"middle_name": "HOGAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2016-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0041545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Snow Hill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.