Kimberly D Pierson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

22837 Issued in CA

Practice address

31625 De Portola Rd Ste 101
Temecula, CA 92592-2770

Phone

(951) 501-4200

NPI assigned

Feb 9, 2007

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 D Boutain Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Trinity Medical Multi-Specialty Group Inc.

  • Gastroenterology Physician
  • Temecula, CA
  • NPI 1598399917
  Medicare reassignment

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1376684514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 LOMITA BLVD",
            "address_2": "STE 442",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054801",
            "telephone_number": "310-530-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31625 DE PORTOLA RD STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925922770",
            "telephone_number": "951-501-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSON",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BOUTAIN",
            "middle_name": "D",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aaron Piecukonis
• Cody Piecukonis
• Elizabeth Leigh Pierce
• Kenneth W Pierce, DC
• Piernas Marriage & Family Therapy Inc.
• Leslie Pimentel
• Jennifer Pinal
• Taylor Caitlin Pinch
• Jerry Pine, M.DIV., ED.S.
• Sarahi Pinon

• Physician Assistant in Temecula, CA
• Providers in Temecula, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.