Active NPI
Beth C Kimball, MD
- Surgery Physician
- Ypsilanti, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4301056106
- Practice address
- 5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633 - Phone
- (734) 712-8150
- Fax
- (734) 712-8151
- NPI assigned
- Jun 8, 2006
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301056106 | MI | Primary |
Addresses
Primary practice location
5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633
Mailing address
5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633
Phone (734) 712-8150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4146934-10 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Chicago, Pritzker School of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677
44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700
51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304
5301 E Huron River Dr
Ypsilanti, MI 48197-1051
5301 McAuley Dr
Ypsilanti, MI 48197-1051
5303 Elliott Dr
Suite 202
Ypsilanti, MI 48197-8632
Phone (734) 712-2005
5315 Elliott Dr
Ypsilanti, MI 48197-8634
Hospital & facility affiliations
- Trinity Health Ann Arbor Hospital
- Chelsea Hospital
- St Joe Mercy Hospital System Livonia
- Trinity Health Livingston Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 15 |
| Melanoma (skin cancer) excision | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iha Health Services Corporation | Surgery | Current | Accepting new patients |
| Iha Health Services Corporation | Current | Accepting new patients | |
| Iha Health Service Corporation | Current | Accepting new patients | |
| Michigan Multispecialty Physicians, P.C. | Surgery | Past | Accepting new patients |
| Iha Health Services Corporation | Past | Accepting new patients |
Locations
16507 Southfield Rd
Allen Park, MI 48101
Phone (313) 389-0648
7575 Grand River Rd
Ste 202
Brighton, MI 48114
Phone (810) 844-7566
2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840
49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800
128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677
44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700
5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020
5333 McAuley Dr
Rm 2115
Ypsilanti, MI 48197
Phone (734) 712-3971
5325 Elliott Dr
Ste 104
Ypsilanti, MI 48197
Phone (734) 434-4200
5320 Elliott Dr
Rm 203
Ypsilanti, MI 48197
Phone (734) 712-1700
5333 McAuley Dr
Rm 3001
Ypsilanti, MI 48197
Phone (734) 712-4120
Interoperability endpoints
- bkimball44577@direct.trinity-health.org
Organizations & group practices 5
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.
-
- Obstetrics & Gynecology Physician
- Canton, MI
- NPI 1457408965
-
- Obstetrics & Gynecology Physician
- Ypsilanti, MI
- NPI 1831053701
-
- Surgery Physician
- Ypsilanti, MI
- NPI 1255470233
-
- Family Medicine Physician
- Milan, MI
- NPI 1467509067
-
- Critical Care Medicine (Internal Medicine) Physician
- Ypsilanti, MI
- NPI 1912941337
Surgery
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brighton, MI
- NPI 1093748642
-
- General Acute Care Hospital
- Chelsea, MI
- NPI 1992761985
-
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
-
- General Acute Care Hospital
- Livonia, MI
- NPI 1790706901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348012800000",
"number": "1508806357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5325 ELLIOTT DR",
"address_2": "SUITE 104",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978633",
"telephone_number": "734-712-8150",
"fax_number": "734-712-8151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5325 ELLIOTT DR",
"address_2": "SUITE 104",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978633",
"telephone_number": "734-712-8150",
"fax_number": "734-712-8151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBALL",
"first_name": "BETH",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2012-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301056106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4146934-10",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.