Kimberly Ann Mancl, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME132443 Issued in FL

Practice address

14071 Metropolis Ave
Fort Myers, FL 33912-4330

Phone

(239) 694-7546

Fax

(239) 694-1571

NPI assigned

Mar 24, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Ann Kolstedt Former name

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Miami, LM Miller School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Solutions a Profession Limited Liability ComGroup PAC ID 5294801742, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.43 of 100Reported as individual

Quality

96.86

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Dermatology Solutions a Profession Limited Liability Com

  • Dermatology Physician
  • Fort Myers, FL
  • NPI 1750558516
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1346582756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14071 METROPOLIS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124330",
            "telephone_number": "239-694-7546",
            "fax_number": "239-694-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14071 METROPOLIS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124330",
            "telephone_number": "239-694-7546",
            "fax_number": "239-694-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCL",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-24",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME132443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KOLSTEDT",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Malt, MED
• Candice Roseann Maltezos, CRT
• Wendy Maltezos, LPN
• Timur Mamedov, M.D.
• Michael S. Mancano
• Mandala Counseling Services LLC
• Archana Reddy Mandala, M.D.
• Robert Marc Mandelkorn, M.D.
• George Timothy Mandybur, M.D.
• Elise N Manee, PHARMD

• Dermatology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.