Individual provider Active NPI

Kimiye R.F. Cabrera, M.D.

  • Surgery Physician
  • Bryan, TX
National Provider Identifier
1477679355
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
P1625 Issued in TX
Practice address
2700 E 29TH St Ste 105
Bryan, TX 77802-2507
Phone
(979) 776-5631
Fax
(979) 776-6184
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD 15339R LA
Surgery Physician 208600000X P1625 TX Primary

Addresses

Primary practice location

2700 E 29TH St Ste 105
Bryan, TX 77802-2507

Mailing address

2700 E 29TH St Ste 105
Bryan, TX 77802-2507
Phone (979) 776-5631

Other identifiers 1

IdentifierTypeStateIssuer
926800MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050513000146 TX Practitioner - General Surgery 1557302155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Oregon Health Sciences University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Chinle Comprehensive Health Care FacilityGroup PAC ID 9436062585, 160 clinicians

Practice addresses (Care Compare)

Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030

PO Box PH
Chinle, AZ 86503-8000

Hospital & facility affiliations

  • Chinle Comprehensive Health Care Facility Hospital, Chinle, AZ, CCN 030084

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18
Upper gastrointestinal (GI) endoscopy for acid reflux14
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 15339RLAMDSurgery Physician
P1625TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility Current Accepting new patients
Jonathan a. Friedman, M.D., PLLC Past Accepting new patients
St Joseph Physician Associates Surgery Past Accepting new patients

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1477679355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 E 29TH ST STE 105",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022507",
            "telephone_number": "979-776-5631",
            "fax_number": "979-776-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E 29TH ST STE 105",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022507",
            "telephone_number": "979-776-5631",
            "fax_number": "979-776-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "KIMIYE",
        "middle_name": "R.F.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "MD 15339R",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "P1625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926800",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.