Kimberly Hasenboehler, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C04626 Issued in MD

Practice address

8923 Grummore Cir
Pikesville, MD 21208-1427

Phone

(720) 979-1002

NPI assigned

Oct 17, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Northwest Hospital Center IncGroup PAC ID 6204739352, 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040

Merit-based Incentive Payment System (MIPS)

Final score

82.34 of 100Reported as group

Quality

67.9

Promoting interoperability

100

Improvement activities

40

Cost

69.47

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Northwest Hospital Center, Inc

  • Hospitalist Physician
  • Randallstown, MD
  • NPI 1508961988
  Medicare reassignment Care Compare group NPD
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187
  Medicare reassignment Care Compare group
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD
• Northwest Hospital Center, Inc.

  • General Acute Care Hospital
  • Randallstown, MD
  • NPI 1487695888
  NPD (past)

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

• Northwest Hospital Center, Inc.

  • General Acute Care Hospital
  • Randallstown, MD
  • NPI 1487695888
  Care Compare affiliation

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1669552923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8923 GRUMMORE CIR",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081427",
            "telephone_number": "720-979-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8923 GRUMMORE CIR",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081427",
            "telephone_number": "720-979-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASENBOEHLER",
        "first_name": "KIMBERLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C04626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8D9264",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• A'Dona Harrison
• Keenan Alexander Harrison
• Deandra Harry
• Grace Ann Hartfiel-Carr, OTR/L
• Shakena Harvey
• Ayah Ehab Hassan
• Tricia Hasson
• Hastings Nutrition LLC
• Salome Hawkins-Cole, D.O.
• Zanyah Hawkins-Walker

• Surgical Physician Assistant in Pikesville, MD
• Providers in Pikesville, MD by specialty
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.