Kristin Nicole Somerville, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C0004260 Issued in MD

Practice address

6701 N Charles St
Baltimore, MD 21204-6808

Phone

(443) 849-2000

NPI assigned

Aug 27, 2010

Sex

Female

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 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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdelbalzo6234@gbmcdirect.org

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.

• Greater Baltimore Medical Center, Inc

  • Obstetrics & Gynecology Physician
  • Baltimore, MD
  • NPI 1891855763
  Medicare reassignment Care Compare group
• Greater Baltimore Medical Center, Inc.

  • General Practice Physician
  • Baltimore, MD
  • NPI 1396774238
  NPD
• Greater Baltimore Medical Center, Inc.

  • Sleep Medicine (Internal Medicine) Physician
  • Baltimore, MD
  • NPI 1538029731
  NPD
• Greater Baltimore Medical Center, Inc.

  • Medical Oncology Physician
  • Baltimore, MD
  • NPI 1235167297
  NPD (past)

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

• Greater Baltimore Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1255372397
  Care Compare affiliation

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1265748263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 N CHARLES ST STE 510",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045832",
            "telephone_number": "443-849-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "443-849-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "KRISTIN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004260",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0004260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Somers, FNP-BC
• Megan Elizabeth Somersall, LGSW
• Anthony E Somerville
• Averie Somerville
• Kai Mason Somerville
• Renita Monique Somerville, LCSW-C
• Sierra Octavia Somerville
• Abiodun Somide, PHARMD
• Alfred Sommer, M.D.
• Jill Erin Sommer

• Surgical Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.