Kimberly Irene Bade, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007904 Issued in MI

Practice address

47601 Grand River Ave
Novi, MI 48374-1233

Phone

(248) 849-8721

Fax

(248) 849-8507

NPI assigned

Oct 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Henry Ford Health Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Pro Health Medical Inc

  • Urgent Care Clinic/Center
  • Rochester Hills, MI
  • NPI 1649781733
  Medicare reassignment
• Henry Ford Health Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  NPD
• Pro-Health Medical FP

  • Primary Care Clinic/Center
  • Lake Orion, MI
  • NPI 1740841451
  NPD (past)
• Florida Hospital Medical Group Inc

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD (past)

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

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1578013397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 N ALEXANDER AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673630",
            "telephone_number": "248-765-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47601 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741233",
            "telephone_number": "248-849-8721",
            "fax_number": "248-849-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADE",
        "first_name": "KIMBERLY",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9109996",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Bachman, PTA
• William Henry Bachman, MD
• Jinger Bachtel
• Kelsey Back
• Ryan Bacon
• Breanne Jauan Badger
• Brittany D Badgley
• Sara Baerlocher
• Ezequiel Baez-Dejesus
• Marissa Baffaro

• Physician Assistant in Novi, MI
• Providers in Novi, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.

Verify at the official NPI Registry.