Individual provider Active NPI

Kimberly A Morrissette, D.O.

  • Emergency Medicine Physician
  • Worcester, MA
National Provider Identifier
1689733057
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
230673 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 421-1400
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 230673 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 421-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20080522000197 WA Practitioner - Emergency Medicine 7618046293 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of New England, College of Osteo Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

13020 Meridian Ave S
Everett, WA 98208-6468
Phone (425) 357-3910

18100 NE Union Hill Rd
Redmond, WA 98052-3330
Phone (425) 498-2020

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 394-0610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230673MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tacoma Emergency Care Physicians, PLLC Emergency Medicine Current Accepting new patients
Tacoma Emergency Care Physicians, PLLC Emergency Medicine CurrentSince May 1, 2013 Accepting new patients
Eastside Emergency Physicians, PLLC Emergency Medicine CurrentSince Feb 20, 2016 Accepting new patients
Multicare Health System CurrentSince Oct 26, 2015 Accepting new patients
Eastside Emergency Physicians, PLLC Emergency Medicine CurrentSince Feb 20, 2016 Accepting new patients
Swedish Health Services CurrentSince Dec 12, 2017 Accepting new patients
Multicare Health System Current Accepting new patients
Swedish Health Services CurrentSince Dec 12, 2017 Accepting new patients
Multicare Health System CurrentSince Oct 26, 2015 Accepting new patients
Eastside Emergency Physicians PLLC Emergency Medicine Current Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

751 NE Blakely Dr
Issaquah, WA 98029
Phone (425) 313-4000

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 498-2020

18100 NE Union Hill Rd
Ste 200
Redmond, WA 98052
Phone (206) 320-5190

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 10

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 2

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1689733057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISSETTE",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "230673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.