NPIMap

Individual provider Active NPI

Kimberlee Mudge, MD

  • Surgery Physician
  • York, PA
National Provider Identifier
1366425316
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD053182L Issued in PA
Practice address
1703 Innovation Drive
Suite 3136
York, PA 17408-8815
Phone
(717) 741-3449
Fax
(717) 741-5496
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD053182L PA Primary

Addresses

Primary practice location

1703 Innovation Drive
Suite 3136
York, PA 17408-8815

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612
Phone (717) 741-3449

Other practice location 1

25 Monument Rd
Suite 260
York, PA 17403-5060
Phone (717) 741-3449

Other identifiers 1

IdentifierTypeStateIssuer
1597216MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmudge65642@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921001144 PA Practitioner - General Surgery 3072537687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

1701 Innovation Dr
York, PA 17408-8815
Phone (717) 843-8623

1703 Innovation Dr
York, PA 17408-8815

2501 N 3Rd St
Kline Health Center Foot and Ankle
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd St 2ND FL Kline HC
Reach Program
Harrisburg, PA 17110-1904
Phone (717) 782-2363

2501 N 3Rd St FL
2 Kline Health Center
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd Street 2ND Floor
Pinnaclehealth Psychological Associates
Harrisburg, PA 17110-1904
Phone (717) 782-2143

Hospital & facility affiliations

  • Upmc Memorial Hospital, York, PA, CCN 390101
  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Upmc Hanover Hospital, Hanover, PA, CCN 390233
  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy45
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD053182LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Leader Surgery Center, LLC CurrentSince Jul 1, 2014 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2019 Accepting new patients
Pinnacle Health Medical Services Surgery Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2019 Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients

Locations

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

25 Monument Rd
Ste 260
York, PA 17403
Phone (717) 741-3449

1703 Innovation Dr
Ste 3136
York, PA 17408
Phone (717) 741-3449

Interoperability endpoints

  • Direct secure messaging: kmudge19331@upmc.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1366425316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612",
            "telephone_number": "717-741-3449",
            "fax_number": "717-741-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 INNOVATION DRIVE",
            "address_2": "SUITE 3136",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174088815",
            "telephone_number": "717-741-3449",
            "fax_number": "717-741-5496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Monument Rd",
            "address_2": "SUITE 260",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035060",
            "country_code": "US",
            "telephone_number": "717-741-3449",
            "fax_number": "717-741-5496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUDGE",
        "first_name": "KIMBERLEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD053182L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1597216",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmudge65642@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "1703 Innovation Drive",
            "address_2": "Suite 3136",
            "city": "York",
            "state": "PA",
            "country_code": "US",
            "postal_code": "174088815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.