Individual provider Active NPI

Kimberly A Zimmerman, O.D.

  • Optometrist
  • Harrisburg, PA
National Provider Identifier
1407998982
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000482 Issued in PA
Practice address
2745 N Front St
Harrisburg, PA 17110-1265
Phone
(717) 238-6757
Fax
(717) 238-6541
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000482 PA Primary

Addresses

Primary practice location

2745 N Front St
Harrisburg, PA 17110-1265

Mailing address

513 S Pitt St
Carlisle, PA 17013-3821
Phone (717) 245-2114

Other identifiers 1

IdentifierTypeStateIssuer
01940046MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20040902001180 PA Practitioner - Optometry 5395711196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Eye Care Group, Inc.Group PAC ID 5890762561, 5 clinicians

Practice addresses (Care Compare)

92 Tuscarora St
Harrisburg, PA 17104-1667
Phone (717) 232-0843

Merit-based Incentive Payment System (MIPS)

Final score
84.48 of 100Reported as group
Quality
100
Improvement activities
40
Cost
48.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Eye Care Group, Inc. Optometrist CurrentSince Jul 1, 2010 Accepting new patients
Premier Eye Care Group, Inc Optometrist CurrentSince Jul 1, 2010 Accepting new patients
Allentown Vision Center, PC Optometrist PastSince Nov 15, 1998 Accepting new patients

Locations

3903 Hartzdale Dr
Camp Hill, PA 17011
Phone (240) 386-2683

92 Tuscarora St
Harrisburg, PA 17104
Phone (717) 232-0843

2745 N Front St
Harrisburg, PA 17110
Phone (717) 238-6757

Organizations & group practices 3

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1407998982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 S PITT ST",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170133821",
            "telephone_number": "717-245-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 N FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171101265",
            "telephone_number": "717-238-6757",
            "fax_number": "717-238-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01940046",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.