Kimberly Ann Jerome, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9106227 Issued in FL

Practice address

1485 Legends Blvd
Champions Gate, FL 33896-8393

Phone

(407) 390-6480

Fax

(407) 390-6483

NPI assigned

Dec 10, 2011

Last updated

Sep 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Pielhau Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Home Health Home health agency, Temple Terrace, FL, CCN 107414
• Amedisys Home Health Home health agency, Winter Haven, FL, CCN 107007
• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjerome74021@adventhealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adventhealth Primary Care Network Inc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1093493637
  Medicare reassignment Care Compare group
• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  Medicare reassignment NPD
• Florida Hospital Physician Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  Medicare reassignment
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD
• DMS Medical LLC

  dba 33 rd Street Medical Center

  • Primary Care Clinic/Center
  • Orlando, FL
  • NPI 1932543758
  NPD (past)

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

• Adventhealth Home Health and Hospice Inc

  dba Adventhealth Home Health

  • Home Health Agency
  • Temple Terrace, FL
  • NPI 1124085238
  Care Compare affiliation
• Adventhealth Polk North Inc

  dba AdventHealth Heart of Florida

  • General Acute Care Hospital
  • Davenport, FL
  • NPI 1801457510
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando Outreach Laboratory

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation
• Amedisys Florida, LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Winter Haven, FL
  • NPI 1982662276
  Care Compare affiliation

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

{
    "created_epoch": "1323475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1518235159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6106 HUCKLEBERRY AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328194176",
            "telephone_number": "407-668-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 LEGENDS BLVD",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "338968393",
            "telephone_number": "407-390-6480",
            "fax_number": "407-390-6483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4551 Pleasant Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Poinciana",
            "state": "FL",
            "postal_code": "347593422",
            "country_code": "US",
            "telephone_number": "407-847-2212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2551 Boggy Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347443806",
            "country_code": "US",
            "telephone_number": "407-348-0990",
            "fax_number": "407-944-9041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEROME",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-10",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PIELHAU",
            "credential": "KIMBERLY BOULDRY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Champions Gate, FL
• Providers in Champions Gate, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.

Verify at the official NPI Registry.