Individual provider Active NPI

Kimberly Rae Tinsley

  • Clinical Social Worker
  • Santa Monica, CA
National Provider Identifier
1811395577
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
80184 Issued in CA
Practice address
954 15TH St Unit 201
Santa Monica, CA 90403-3133
Phone
(213) 488-9559
Fax
(213) 270-9060
NPI assigned
Dec 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 80184 CA Primary

Addresses

Primary practice location

954 15TH St Unit 201
Santa Monica, CA 90403-3133

Mailing address

954 15TH St Unit 201
Santa Monica, CA 90403-3133
Phone (213) 488-9559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210309002064 CA Practitioner - Clinical Social Worker 2365858719 Reassigns benefits to 1 organization
Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

3152 Ivy St
Los Angeles, CA 90034-3213
Phone (404) 441-5758

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80184CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince Aug 1, 2025 Accepting new patients
Lamp Inc Past Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Interoperability endpoints

  • Direct secure messaging: kimberlytinsley@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1811395577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 15TH ST UNIT 201",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904033133",
            "telephone_number": "213-488-9559",
            "fax_number": "213-270-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 15TH ST UNIT 201",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904033133",
            "telephone_number": "213-488-9559",
            "fax_number": "213-270-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINSLEY",
        "first_name": "KIMBERLY",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.