Active NPI
Kimberly A Bastible, MS, RPA-C
- Physician Assistant
- Huntington, NY
National Provider Identifier
1598856536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004911
- Practice address
- 18 Harmony Rd
Huntington, NY 11743-2316 - Phone
- (631) 813-9199
- NPI assigned
- Sep 27, 2006
- Last updated
- Apr 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004911 | NY | Primary |
Addresses
Primary practice location
18 Harmony Rd
Huntington, NY 11743-2316
Mailing address
18 Harmony Rd
Huntington, NY 11743-2316
Phone (631) 813-9199
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004911 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207699200000",
"number": "1598856536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 HARMONY RD",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117432316",
"telephone_number": "631-813-9199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 HARMONY RD",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117432316",
"telephone_number": "631-813-9199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTIBLE",
"first_name": "KIMBERLY",
"middle_name": "A",
"credential": "MS, RPA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2008-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.