Active NPI
Jenna Kimmerle
- Physician Assistant
- Shrewsbury, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00592100
- Practice address
- 535 Sycamore Ave
Shrewsbury, NJ 07702-4224 - Phone
- (732) 741-0970
- NPI assigned
- Nov 5, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00592100 | NJ | Primary |
Addresses
Primary practice location
535 Sycamore Ave
Shrewsbury, NJ 07702-4224
Mailing address
409 Kettle Creek Rd Apt 3
Toms River, NJ 08753-1977
Phone (570) 575-5136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Schulz Dr
Suite 2
Red Bank, NJ 07701-6745
331 Newman Springs Rd
Red Bank, NJ 07701-5688
Phone (732) 741-0970
525 Route 70 E
Suite 2a
Brick, NJ 08723
Phone (732) 333-8720
535 Sycamore Ave
Shrewsbury, NJ 07702-4224
Phone (732) 333-8720
Hospital & facility affiliations
- Ocean Medical Center
- Jersey Shore University Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Woods O.R., Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Plastic and Reconstructive Surgery Physician
- Red Bank, NJ
- NPI 1386613834
-
- Ambulatory Surgical Clinic/Center
- Tinton Falls, NJ
- NPI 1952610768
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brick, NJ
- NPI 1477065126
-
- General Acute Care Hospital
- Neptune, NJ
- NPI 1790297547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1467053322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 KETTLE CREEK RD APT 3",
"city": "TOMS RIVER",
"state": "NJ",
"postal_code": "087531977",
"telephone_number": "570-575-5136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 SYCAMORE AVE",
"city": "SHREWSBURY",
"state": "NJ",
"postal_code": "077024224",
"telephone_number": "732-741-0970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMMERLE",
"first_name": "JENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-05",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00592100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shrewsbury, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.