Individual provider Active NPI

Katelyn Zimmer

  • Dermatology Physician
  • Madison, AL
National Provider Identifier
1689028029
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
38989 Issued in AL
Practice address
8331 Madison Blvd Ste 300
Madison, AL 35758-2073
Phone
(256) 705-3000
NPI assigned
Apr 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 38989 AL Primary

Addresses

Primary practice location

8331 Madison Blvd Ste 300
Madison, AL 35758-2073

Mailing address

8331 Madison Blvd Ste 300
Madison, AL 35758-2073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20200526002785 AL Practitioner - Dermatology 7416244827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Saint Louis University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Skin Cancer and DermatologyGroup PAC ID 0648427856, 9 clinicians

Practice addresses (Care Compare)

104 J E Briscoe Way
Madison, AL 35758-4822
Phone (256) 705-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.56 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
78.53

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision43
Removal of skin lesions434
Removal or shaving of skin growth17
Skin biopsy80

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Skin Cancer & Dermatology CurrentSince Aug 1, 2020 Accepting new patients

Locations

8331 Madison Blvd
Ste 300
Madison, AL 35758
Phone (256) 705-3000

104 J E Briscoe Way
Madison, AL 35758
Phone (256) 705-3000

Interoperability endpoints

  • Direct secure messaging: kzimmer@sederm.emadirect.md

Organizations & group practices 1

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 1

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": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1689028029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8331 MADISON BLVD STE 300",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8331 MADISON BLVD STE 300",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582073",
            "telephone_number": "256-705-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "38989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.