Individual provider Active NPI

Kimberly King, PA-C

  • Surgical Physician Assistant
  • Dedham, MA
National Provider Identifier
1295257467
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA6099 Issued in MA
Practice address
1 Lyons St
Dedham, MA 02026-5599
Phone
(617) 877-9174
NPI assigned
Jul 10, 2017
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA6099 MA Primary

Addresses

Primary practice location

1 Lyons St
Dedham, MA 02026-5599

Mailing address

1 Lyons St
Dedham, MA 02026-5599
Phone (617) 654-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170809003148 MA Practitioner - Physician Assistant 9436420411 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1 Lyons St
Dedham, MA 02026-5599
Phone (781) 329-1400

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

20 Wall St
Burlington, MA 01803-4758
Phone (781) 221-2500

228 Billerica Rd
Chelmsford, MA 01824-3604
Phone (978) 250-6000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Nov 14, 2022 Accepting new patients
Orthopedic Care Physician Network LLC CurrentSince Mar 8, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 14, 2022 Accepting new patients
Atrius Health, Inc. CurrentSince Sep 15, 2023 Accepting new patients
Orthopedic Care Physician Network, LLC CurrentSince Mar 8, 2022 Accepting new patients
Atrius Health, Inc. CurrentSince Sep 15, 2023 Accepting new patients

Locations

147 Milk St
Boston, MA 02109
Phone (617) 421-2508

75 Francis St
Boston, MA 02115

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

1 Lyons St
Dedham, MA 02026
Phone (781) 278-5511

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

15 Roche Brothers Way
North Easton, MA 02356
Phone (781) 545-9273

Interoperability endpoints

  • Direct secure messaging: kkealeypa373574@direct.atrius.masshiway.net

Organizations & group practices 7

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": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1295257467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LYONS ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020265599",
            "telephone_number": "617-654-7111",
            "fax_number": "781-461-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LYONS ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020265599",
            "telephone_number": "617-877-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KIMBERLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA6099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.