Nathaniel Guy Jimenez
Individual provider Active NPI Emergency Medical Services (Emergency Medicine) Physician · Jber, AK
NPI 1639539596 · NPPES record last updated Jan 10, 2022
Key facts
- NPI
- 1639539596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
- License
- 30885 (NE)
- Practice address
- 5955 Zeamer Ave
Jber, AK 99506-3702 - Phone
- (907) 580-5556
- NPI assigned
- Mar 3, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 19
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- St. Louis College of Physicians and Surgeons, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Central Peninsula General Hospital Inc
Practice addresses (Care Compare)
250 Hospital PL
Soldotna, AK 99669-7559
Phone (907) 714-4515
Hospital & facility affiliations
- Central Peninsula General Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75.44 of 100
- Quality
- 62.56
- Promoting interoperability
- 81
- Improvement activities
- 40
- Cost
- 67.88
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211117002452 | AK | Practitioner - Emergency Medicine | 6608162938 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30885 | NE | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Peninsula General Hospital, Inc | Current |
Accepting new patients | |
| Central Peninsula General Hospital Inc. | Current | Accepting new patients | |
| Central Peninsula General Hospital Inc | Current |
Accepting new patients | |
| North Star Medical Imaging PLLC | Current | Accepting new patients |
Locations
250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404
Interoperability endpoints
- njimenez2017053@ak.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 162368 | AK | |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 30885 | NE | Yes |
Addresses
Primary practice location
5955 Zeamer Ave
Jber, AK 99506-3702
Mailing address
5955 Zeamer Ave
Jber, AK 99506-3702
Phone (907) 580-5556
Other practice location 1
250 Hospital Pl
Soldotna, AK 99669-6999
Phone (907) 714-4444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1724276 | Medicaid | AK |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | njimenez2017053@ak.providencedirect.org | Health Information Exchange (HIE) |
Other providers in Jber, AK
- Krista K Hutchinson
- Joseph Inhofer
- Samuel Alexander Islas
- Rebecca Michelle Jackson
- Michael Jessup
- Megan Ann John
- David L Johnson
- Shannon Johnson
- Valerie Carol Johnson
- David Augustin Jung
All providers in Jber, AK · Emergency Medical Services (Emergency Medicine) Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.