Kimberly Fusselman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2025-0024 Issued in NM

Practice address

490A W Zia Rd
Santa Fe, NM 87505-6996

Phone

(505) 913-8900

NPI assigned

Mar 6, 2025

Last updated

Mar 6, 2025By 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 names 1

• Kimberly Scott Former name

Medicare fee-for-service enrollment

Enrolled in NM

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kfusselman584086@christushealth.direct-ci.net

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.

• St Vincent Hospital

  dba CHRISTUS St. Vincent Pediatrics

  • Pediatrics Physician
  • Santa Fe, NM
  • NPI 1063367803
  Medicare reassignment Care Compare group
• St. Vincent Hospital

  dba CHRISTUS St. Vincent Adult and Family Care

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1245438647
  NPD

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

• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1669270310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 DIETZ FARM RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871073117",
            "telephone_number": "505-715-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490A W ZIA RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056996",
            "telephone_number": "505-913-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSELMAN",
        "first_name": "KIMBERLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2025-0024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SCOTT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul S Fullerton, D.O.
• Sara Fullerton
• Cynthia Fulreader, LPC
• Kendra Furgason, RN
• Lauren Katie Fusek, FNP
• G&L Medical LLC
• Denise Gabaldon-Thronas, DN
• Alexandra Gabaldon
• Amanda M Gabaldon
• Richard Gabaldon

• Physician Assistant in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.