Samuel Kimbrough, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1701 Renaissance Blvd Ste 110
Edmond, OK 73013-3084

Phone

(405) 844-4978

NPI assigned

Mar 21, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Physician Assistant

Education

University of North Texas HSC, College of Osteopathic Med, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oklahoma Arthritis Center, P.C.Group PAC ID 0446239743, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
• Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236
• Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049
• Weatherford Regional Hospital, Inc of Weatherford Hospital, Weatherford, OK, CCN 371323

Merit-based Incentive Payment System (MIPS)

Final score

74.12 of 100Reported as group

Quality

64.14

Promoting interoperability

75

Improvement activities

40

Cost

70.43

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: samuelkimbrough@oac.allscriptsdirect.net

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.

• Oklahoma Arthritis Center, P.C.

  • Rheumatology Physician
  • Edmond, OK
  • NPI 1528036019
  Medicare reassignment Care Compare group
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Integris Health Edmond, Inc

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1720373103
  Care Compare affiliation
• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  Care Compare affiliation
• Stillwater Medical Center Authority

  • General Acute Care Hospital
  • Stillwater, OK
  • NPI 1164494027
  Care Compare affiliation
• Weatherford Hospital Authority

  • Critical Access Hospital
  • Weatherford, OK
  • NPI 1346494275
  Care Compare affiliation
• Weatherford Hospital Authority

  • General Acute Care Hospital
  • Weatherford, OK
  • NPI 1578716502
  Care Compare affiliation
• Weatherford Hospital Authority

  • Critical Access Hospital
  • Weatherford, OK
  • NPI 1639175185
  Care Compare affiliation

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1265134498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N WALKER AVE APT 8101",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021871",
            "telephone_number": "580-721-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 RENAISSANCE BLVD STE 110",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133084",
            "telephone_number": "405-844-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "SAMUEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Haesook Kim
• Grace Kimani
• Kimberly a. S Pears Me, LPC, Inc.
• Kimberly Dean Ma LMFT PLLC
• Kimberly Edgmon MD, PLLC
• Gina Kincade
• Kindred Wings
• Catherine Marie Kindt, APRN, FNP-C
• Erin Elisabeth King-Bickle, LPC
• Brittany King, PTA

• Physician Assistant in Edmond, OK
• Providers in Edmond, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.

Verify at the official NPI Registry.