NPIMap

Individual provider Active NPI

Kimberly Marie Fern, PA-C

  • Physician Assistant
  • Annapolis, MD
National Provider Identifier
1245535749
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C04388 Issued in MD
Practice address
170 Jennifer Rd Ste 240
Annapolis, MD 21401-7995
Phone
(410) 571-9000
Fax
(410) 266-1507
NPI assigned
Jan 14, 2011
Last updated
Sep 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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 C04388 MD Primary

Addresses

Primary practice location

170 Jennifer Rd Ste 240
Annapolis, MD 21401-7995

Mailing address

170 Jennifer Rd Ste 240
Annapolis, MD 21401-7995
Phone (410) 571-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111230000299 MD Practitioner - Physician Assistant 1254507965 Reassigns benefits to 6 organizations
I20260527002533 DC Practitioner - Physician Assistant 1254507965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brian S Kahan DO PAGroup PAC ID 6709873136, 2 clinicians

Practice addresses (Care Compare)

170 Jennfer Rd
Suite 240
Annapolis, MD 21401-7995
Phone 41057190000230

2635 Riva Rd
Suite 118
Annapolis, MD 21401-7430
Phone (410) 571-9000

Merit-based Incentive Payment System (MIPS)

Final score
83.17 of 100Reported as group
Quality
69.86
Promoting interoperability
100
Improvement activities
40
Cost
74.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brian S Kahan DO PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kfern@626.securemail.prognocis.com

Organizations & group practices 8

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": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1245535749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 JENNIFER RD STE 240",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017995",
            "telephone_number": "410-571-9000",
            "fax_number": "410-266-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 JENNIFER RD STE 240",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017995",
            "telephone_number": "410-571-9000",
            "fax_number": "410-266-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERN",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C04388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.