Individual provider Active NPI

Kimberley Yvette Smith, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Vineland, NJ
National Provider Identifier
1679648646
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
MA079203 Issued in NJ
Practice address
352 S Delsea Dr Ste C
Vineland, NJ 08360-5306
Phone
(856) 690-1616
Fax
(856) 690-1089
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X MA079203 NJ Primary

Addresses

Primary practice location

352 S Delsea Dr Ste C
Vineland, NJ 08360-5306

Mailing address

352 S Delsea Dr Ste C
Vineland, NJ 08360-5306
Phone (856) 690-1616

Other names 1

  • Dr. Kimberley Yvette Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051031000305 NJ Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 1355366568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Temple University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 Tomlin Station Rd C
Mullica Hill, NJ 08062-1612
Phone (856) 690-1616

Hospital & facility affiliations

  • Inspira Medical Center Vineland Hospital, Vineland, NJ, CCN 310032
  • Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069

Merit-based Incentive Payment System (MIPS)

Final score
23.77 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
79.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA079203NJMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC CurrentSince Sep 12, 2005 Accepting new patients
Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC CurrentSince Sep 12, 2005 Accepting new patients

Locations

525 State St
Ste 2
Elmer, NJ 08318
Phone (856) 358-2559

330 Front St
Elmer, NJ 08318
Phone (609) 358-0770

201 Tomlin Station Rd
Ste C
Mullica Hill, NJ 08062

352 S Delsea Dr
Unit C
Vineland, NJ 08360
Phone 8566901616 ext. 6021

298 S Delsea Dr
Vineland, NJ 08360
Phone (356) 690-1616

Interoperability endpoints

  • Direct secure messaging: kimberley.smith@poasnj.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1679648646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 S DELSEA DR STE C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605306",
            "telephone_number": "856-690-1616",
            "fax_number": "856-690-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 S DELSEA DR STE C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605306",
            "telephone_number": "856-690-1616",
            "fax_number": "856-690-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLEY",
        "middle_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "MA079203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "SMITH",
            "middle_name": "YVETTE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.