NPIMap

Individual provider Active NPI

Kimberly Pish, DO

  • Family Medicine Physician
  • Williamsport, PA
National Provider Identifier
1821225681
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS015985 Issued in PA
Practice address
1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone
(570) 320-7680
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS015985 PA Primary

Addresses

Primary practice location

1100 Grampian Blvd
Williamsport, PA 17701-1907

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900

Other names 1

  • Kimberly Jones Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kpish200700@upmc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120906000379 PA Practitioner - Family Practice 6406003987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone (570) 320-7691

Hospital & facility affiliations

  • Family Hospice Hospice, Williamsport, PA, CCN 391513
  • Family Hospice Hospice, Altoona, PA, CCN 391505
  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045
  • Upmc Muncy Hospital, Muncy, PA, CCN 391301
  • Upmc Wellsboro Hospital, Wellsboro, PA, CCN 391316

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015985PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services Family Medicine CurrentSince May 1, 2022 Accepting new patients

Locations

1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

1201 Grampian Blvd
Ste 1K
Williamsport, PA 17701

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

Interoperability endpoints

  • Direct secure messaging: kpish200700@upmc.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Family HospiceWilliamsport, PA, CCN 391513 Hospice W-2 Managing Employee Nov 1, 2024

Owned or controlled facilities with NPI records 1

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

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1821225681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011907",
            "telephone_number": "570-320-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISH",
        "first_name": "KIMBERLY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2026-09-01",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS015985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpish200700@upmc.direct-ci.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "JONES",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.