Individual provider Active NPI

Kimberlee Brooke Hobizal, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Beaver Falls, PA
National Provider Identifier
1467763003
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC006197 Issued in PA
Practice address
2620 Constitution Blvd Ste 104
Beaver Falls, PA 15010-1278
Phone
(412) 830-7837
Fax
(412) 909-4168
NPI assigned
Jun 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006197 PA Primary

Addresses

Primary practice location

2620 Constitution Blvd Ste 104
Beaver Falls, PA 15010-1278

Mailing address

2620 Constitution Blvd Ste 104
Beaver Falls, PA 15010-1278
Phone (412) 830-7837

Other practice location 1

1030 Beaner Hollow Rd
Beaver, PA 15009-9723
Phone (724) 775-4242

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
I20140813000154 PA Practitioner - Podiatry 9537386669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2620 Constitution Blvd
Suite 104
Beaver Falls, PA 15010-1278
Phone (412) 830-7837

Hospital & facility affiliations

  • Heritage Valley Beaver Hospital, Beaver, PA, CCN 390036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006197PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Foot and Ankle Reconstructive Surgery PLLC Foot & Ankle Surgery CurrentSince Jun 26, 2024 Accepting new patients
GPS Cranberry LLC. CurrentSince Dec 18, 2024 Accepting new patients
Premier Foot and Ankle PLLC Foot & Ankle Surgery CurrentSince Sep 23, 2024 Accepting new patients

Locations

2620 Constitution Blvd
Ste 104
Beaver Falls, PA 15010
Phone (412) 830-7837

51 Dutilh Rd
Ste 100
Cranberry Twp, PA 16066
Phone (412) 683-4504

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7838/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1467763003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 CONSTITUTION BLVD STE 104",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150101278",
            "telephone_number": "412-830-7837",
            "fax_number": "412-909-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 CONSTITUTION BLVD STE 104",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150101278",
            "telephone_number": "412-830-7837",
            "fax_number": "412-909-4168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 Beaner Hollow Rd",
            "address_purpose": "LOCATION",
            "city": "Beaver",
            "state": "PA",
            "postal_code": "150099723",
            "country_code": "US",
            "telephone_number": "724-775-4242",
            "fax_number": "724-775-4960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOBIZAL",
        "first_name": "KIMBERLEE",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Falls, PA

Sources for this page

Verify at the official NPI Registry.