Active NPI
Kimberly Ann Benton
- Advanced Practice Midwife
- Irvine, CA
National Provider Identifier
1619798808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 236494
- Practice address
- 16305 Sand Canyon Ave
Irvine, CA 92618-3782 - Phone
- (949) 829-5500
- NPI assigned
- Oct 21, 2024
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 95032465 | CA | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 95032465 | CA | |
| Advanced Practice Midwife | 367A00000X | 236494 | CA | Primary |
Addresses
Primary practice location
16305 Sand Canyon Ave
Irvine, CA 92618-3782
Mailing address
202 Calle Sonora
San Clemente, CA 92672-2208
Other names 1
- Kimberly Ann Jaramillo
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16305 Sand Canyon Ave
Suite 275
Irvine, CA 92618-3791
Phone (949) 829-5500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95032465 | CA | MD | Women's Health Nurse Practitioner |
| 236494 | CA | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hoag Clinic | Current | Accepting new patients | |
| Hoag Hospital | Past | Accepting new patients |
Locations
16305 Sand Canyon Ave
Ste 275
Irvine, CA 92618
Phone (949) 770-4115
1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624
1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533
Interoperability endpoints
- https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
- kimberly.benton.1@10944.direct.athenahealth.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 2
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.
-
- Primary Care Clinic/Center
- Newport Beach, CA
- NPI 1942799523
-
- General Acute Care Hospital
- Newport Beach, CA
- NPI 1689864365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1619798808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 CALLE SONORA",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926722208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16305 SAND CANYON AVE",
"city": "IRVINE",
"state": "CA",
"postal_code": "926183782",
"telephone_number": "949-829-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTON",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-21",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CA",
"license": "95032465",
"primary": false
},
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "CA",
"license": "95032465",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "CA",
"license": "236494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "JARAMILLO",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.