Kimberly R Bristow, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

13-0001241 Issued in DE

Practice address

1 Centurian Dr
Suite 114
Newark, DE 19713-2137

Phone

(302) 993-0722

Fax

(302) 993-0754

NPI assigned

May 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD, DE2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Douglas J Lavenburg MD PAGroup PAC ID 3476549098, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.15 of 100Reported as group

Quality

100

Improvement activities

40

Cost

73.82

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krbristow@lavenburg.direct.eyemdemr.com

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.

• Douglas J Lavenburg MD PA

  • Optometrist
  • Elkton, MD
  • NPI 1831276385

  DE

  Medicare reassignment Care Compare group NPD
• Retina Vitreous Center of Delaware P.a.

  • Ophthalmology Physician
  • Wilmington, DE
  • NPI 1043230253
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1669430211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CHESAPEAKE BLVD",
            "address_2": "STE C",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "21921",
            "telephone_number": "410-392-4976",
            "fax_number": "410-392-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CENTURIAN DR",
            "address_2": "SUITE 114",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132137",
            "telephone_number": "302-993-0722",
            "fax_number": "302-993-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOW",
        "first_name": "KIMBERLY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "13-0001241",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1463",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116251900",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000542402",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joelle Briggs, NP
• Kayla Bright, PA-C
• Michelle Renata Brill, PT
• Casie W Brinton, PT
• Jennifer Briody, PA-C
• David Britchkow, MD
• Emily Ruth Broadbent, PA-C
• Carmella Broadway
• Yvonne A Brobst, RN
• Karlyn Nichelle Brockenbrough, CRNP

• Optometrist in Newark, DE
• Providers in Newark, DE by specialty
• Optometrist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.