NPIMap

Individual provider Active NPI

Kimberly W Ebb, MD

  • Internal Medicine Physician
  • Leominster, MA
National Provider Identifier
1790777589
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
151001 Issued in MA
Practice address
50 Memorial Dr
Suite 108
Leominster, MA 01453
Phone
(978) 466-2277
Fax
(978) 466-2282
NPI assigned
Aug 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 151001 MA
Internal Medicine Physician 207R00000X 151001 MA Primary

Addresses

Primary practice location

50 Memorial Dr
Suite 108
Leominster, MA 01453

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other identifiers 4

IdentifierTypeStateIssuer
49154OtherMAFALLON
66455OtherHARVARD
3174671MedicaidMA
151001OtherMATUFTS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kebb24127@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051005001068 MA Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 7416972708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Emory University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians of Cape Cod HospitalGroup PAC ID 9638326671, 330 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

27 Park St
Hyannis, MA 02601-5230
Phone (774) 552-6000

60 Hospital Rd
Leominster, MA 01453-2205
Phone (978) 466-2257

Hospital & facility affiliations

  • Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.3 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Aug 31, 2015 Accepting new patients
Physician Onsite, Inc Internal Medicine CurrentSince Apr 1, 2013 Accepting new patients
Physicians of Cape Cod Hospital Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Umass Memorial Medical Group Inc Internal Medicine CurrentSince Aug 31, 2015 Accepting new patients
Umass Memorial Healthalliance Clinton Hospital Inc Past Accepting new patients
Cape Cod Hospital Inc Past Accepting new patients
Leominster Medical Associates Internal Medicine Past Accepting new patients
Wachusett Medical Associates Internal Medicine PastSince Oct 1, 2005 Accepting new patients

Locations

969 Park St
Attleboro, MA 02703
Phone (508) 222-4182

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

100 Hospital Rd
Ste 1B
Leominster, MA 01453
Phone (978) 466-4550

50 Memorial Dr
Ste 108
Leominster, MA 01453
Phone (978) 466-2280

60 Hospital Rd
Leominster, MA 01453
Phone (978) 466-2000

50 Memorial Dr
Ste 205
Leominster, MA 01453
Phone (978) 534-0310

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDFBCA
  • Direct secure messaging: kebb24127@umassmemorial.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healthalliance-Clinton HospitalLeominster, MA, CCN 220001 Hospital Corporate Director May 31, 2021
Healthalliance-Clinton HospitalClinton, MA, CCN 22S001 Hospital Corporate Director Mar 13, 2023
Health Alliance Home Health and HospiceLeominster, MA, CCN 227009 Home health agency W-2 Managing Employee Mar 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 3

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1790777589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DR",
            "address_2": "SUITE 108",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-2277",
            "fax_number": "978-466-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBB",
        "first_name": "KIMBERLY",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MA",
            "license": "151001",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "151001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "49154",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD",
            "identifier": "66455",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3174671",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "151001",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kebb24127@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "50 Memorial Dr",
            "address_2": "Suite 108",
            "city": "Leominster",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "50 Memorial Dr",
            "address_2": "Suite 108",
            "city": "Leominster",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.