Kimberly Ann Edwards, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106467 Issued in FL

Practice address

1750 Tree Blvd Ste 1
St Augustine, FL 32084-5719

Phone

(904) 824-4005

Fax

(904) 824-4009

NPI assigned

Mar 15, 2012

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

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

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

70.4 of 100Reported as group

Quality

47.82

Promoting interoperability

97

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

80.97 of 100Reported as group

Quality

70.19

Promoting interoperability

98

Improvement activities

40

Cost

68.04

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kedwards@northfloridaent.emadirect.md

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.

• Florida ENT Associates, Inc.

  • Otolaryngology Physician
  • West Miami, FL
  • NPI 1184625733
  Medicare reassignment NPD
• Scott D McDowall PLLC

  • Nephrology Physician
  • St Augustine, FL
  • NPI 1134514573
  Medicare reassignment
• N.F.L. Center for Oto-HNS Facial Plastic Surgery P.a.

  • Otolaryngology/Facial Plastic Surgery Physician
  • St Augustine, FL
  • NPI 1851325781
  NPD
• Georgia Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Waycross, GA
  • NPI 1134769714
  NPD (past)

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1639444136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165789",
            "telephone_number": "305-558-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-824-4005",
            "fax_number": "904-824-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-15",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anshernette Deshay Edmond
• Eduardo Dieguez Jr MD PA
• Edward Henry Scarpitti, MD PA
• Franchesca Edwards
• Joseph R Edwards, PT, DPT
• Madison Edwards, RBT
• Heather Dian Eggleston, LMT
• El- Salawy Medical PA
• Elaine S. Sadkowski, LCSW, LLC
• David Anthony Eldridge, D.P.T.

• Physician Assistant in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.

Verify at the official NPI Registry.