Individual provider Active NPI

Kristina Lynne Kamburis, PA-C

  • Physician Assistant
  • Auburn, AL
National Provider Identifier
1720518400
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.1245 Issued in AL
Practice address
1935 E Glenn Ave
Auburn, AL 36830-5998
Phone
(334) 539-8049
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.1245 AL Primary

Addresses

Primary practice location

1935 E Glenn Ave
Auburn, AL 36830-5998

Mailing address

1935 E Glenn Ave
Auburn, AL 36830-5998
Phone (334) 539-8049

Other practice location 1

1720 2nd Ave S
Birmingham, AL 35294-0004
Phone (205) 934-1024

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171023003071 AL Practitioner - Physician Assistant 9830465640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nash Dermatology LLCGroup PAC ID 2163705757, 6 clinicians

Practice addresses (Care Compare)

1935 E Glenn Ave
Suite 101
Auburn, AL 36830-5999
Phone (334) 539-8049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.1245ALMDPhysician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1720518400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 E GLENN AVE",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368305998",
            "telephone_number": "334-539-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 E GLENN AVE",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368305998",
            "telephone_number": "334-539-8049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 2nd Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352940004",
            "country_code": "US",
            "telephone_number": "205-934-1024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMBURIS",
        "first_name": "KRISTINA",
        "middle_name": "LYNNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

Verify at the official NPI Registry.