Tina Renee Kinsley, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35753 Issued in NE

Practice address

16910 Frances St
Omaha, NE 68130-2398

Phone

(402) 505-8777

Fax

(402) 933-7767

NPI assigned

Mar 26, 2007

Last updated

Aug 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NE, CA2 enrollments

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 2

Specialty

Dermatology

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mod Dermatology PCGroup PAC ID 9638430804, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mod Dermatology PC

  • Dermatology Physician
  • Omaha, NE
  • NPI 1982105425
  Medicare reassignment Care Compare group NPD
• Golden State Dermatology Associates Inc.

  • Dermatology Physician
  • Walnut Creek, CA
  • NPI 1700860871
  Medicare reassignment
• Alan Bolton, MD, PC

  • Obstetrics & Gynecology Physician
  • Berkley, MI
  • NPI 1467632901
  NPD
• Audrey Bruell, M.D. P.C.

  • Dermatology Physician
  • Livonia, MI
  • NPI 1306965983
  NPD
• Vein Center at Allure Medical Spa, PLLC

  • Surgery Physician
  • Shelby Township, MI
  • NPI 1457302051

  Dermatology

  NPD (past)

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

• The Nebraska Medical Center

  dba The Nebraska Medical Center - Nebraska Medicine

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356307581
  Care Compare affiliation

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1598883035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16910 FRANCES ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302398",
            "telephone_number": "402-505-8777",
            "fax_number": "402-933-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16910 FRANCES ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302398",
            "telephone_number": "402-505-8777",
            "fax_number": "402-933-7767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1810 N Bell St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "NE",
            "postal_code": "68025",
            "country_code": "US",
            "telephone_number": "402-505-7777",
            "fax_number": "402-933-7767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINSLEY",
        "first_name": "TINA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NE",
            "license": "35753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301102115",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "35753",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1598883035",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey E Kinniburgh, DO
• Malichi Kinnison
• Mary Elizabeth Kinnison
• Theresa Kinnison
• Justin Kinser
• Robert George Kinsman, PT
• Kimber Ann Kinstler, LIMHP
• Jodi M Kintzle-Wynn, APRN
• Katie Kintzle, RN
• Kaylee Marie Kintzle

• Dermatology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Dermatology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.