Individual provider Active NPI

Kimberly Irene Ward, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1801430228
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061130 Issued in PA
Practice address
132 S 10TH St
Philadelphia, PA 19107-5244
Phone
(215) 955-6000
NPI assigned
Oct 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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 MA061130 PA Primary

Addresses

Primary practice location

132 S 10TH St
Philadelphia, PA 19107-5244

Mailing address

1020 Sansom St
Ste 239
Philadelphia, PA 19107-5002
Phone (215) 955-6844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200218000709 PA Practitioner - Physician Assistant 4880021641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Philadelphia, PA 19107-4824

925 Chestnut St
Philadelphia, PA 19107-4204

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA061130PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Acute Care Physicians, PC CurrentSince Dec 31, 2019 Accepting new patients
Jefferson University Physicians CurrentSince Dec 31, 2019 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

132 S 10th St
Philadelphia, PA 19107
Phone (215) 955-6028

2301 S Broad St
Fl 1
Philadelphia, PA 19148
Phone (215) 952-9136

1020 Sansom St
Ste 239
Philadelphia, PA 19107
Phone (215) 955-6844

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 4

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": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1801430228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST",
            "address_2": "STE 239",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075002",
            "telephone_number": "215-955-6844",
            "fax_number": "215-955-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075244",
            "telephone_number": "215-955-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "KIMBERLY",
        "middle_name": "IRENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.