Kimberly Marie Broome, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2481 Issued in FL

Practice address

4313 NW 8TH Ave
Gainesville, FL 32605-4777

Phone

(352) 373-4300

Fax

(352) 372-1641

NPI assigned

Nov 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Florida Professional PLLCGroup PAC ID 3870960032, 70 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Florida Professional PLLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1164156246
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1326029414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 NW 8TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054777",
            "telephone_number": "352-373-4300",
            "fax_number": "352-372-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4313 NW 8TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054777",
            "telephone_number": "352-373-4300",
            "fax_number": "352-372-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078811200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lequita Charmine Brooks, LCSW
• Loina Simon Brooks
• Stephanie Brooks
• Tanner Clark Brooks
• Willie Brooks Jr.
• Sidney Broome, MD
• Torrie Broomfield
• Gina Brophy
• Meagan Elizabeth Brophy
• Whitney Jacob Brophy

• Optometrist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.