Active NPI
Kimberly Sable
- Dermatology Physician
- Chicago, IL
National Provider Identifier
1366070526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 8796851
- Practice address
- 2900 N Lake Shore Dr
Chicago, IL 60657-5640 - Phone
- (773) 665-6730
- NPI assigned
- Mar 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 8796851 | WI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2900 N Lake Shore Dr
Chicago, IL 60657-5640
Mailing address
600 Highland Ave.
Madison, WI 53792
Phone (608) 263-6400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241217003777 | GA | Practitioner - Dermatology | 2163824863 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Loyola University of Chicago, Stritch School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dermatology Associates of Georgia, LLC
Practice addresses (Care Compare)
1951 Clairmont Rd
Decatur, GA 30033-3415
Phone (404) 321-4600
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 44 |
| Removal of skin lesions | 58 |
| Removal of skin cancer | 173 |
| Skin biopsy | 49 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology Associates of Georgia, LLC | Current | Accepting new patients |
Locations
1951 Clairmont Rd
Decatur, GA 30033
Phone (404) 321-4600
201 Michael Etchison Rd
Monroe, GA 30655
Phone (770) 267-5877
Interoperability endpoints
- kimberly.sable.p1@direct.dermga.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625270400000",
"number": "1366070526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE.",
"city": "MADISON",
"state": "WI",
"postal_code": "53792",
"telephone_number": "608-263-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 N LAKE SHORE DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606575640",
"telephone_number": "773-665-6730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SABLE",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-31",
"last_updated": "2021-07-03",
"certification_date": "2021-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WI",
"license": "8796851",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; 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.