Kimberly Lynn Eustache, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301108097 Issued in MI

Practice address

1 Genesys Pkwy
Medical Education Dept. 4626
Grand Blanc, MI 48439-8065

Phone

(810) 606-6372

Fax

(810) 606-5990

NPI assigned

Jun 11, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, PA, CA, OK, TX5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 5

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

94.51

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.51 of 100Reported as group

Quality

84.87

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 43)

Interoperability endpoints

• Direct secure messaging: keustache558742@ahs.direct-ci.com

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.

• Ahn Emergency Group of Forbes LTD.

  • Emergency Medicine Physician
  • Monroeville, PA
  • NPI 1235554692
  Medicare reassignment NPD
• Ahn Emergency Group of Pittsburgh LTD.

  • Emergency Medicine Physician
  • Pittsburgh, PA
  • NPI 1043635402
  Medicare reassignment NPD
• County of Santa Clara

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• Emergency Medicine Physicians of Cuyahoga County, LTD

  • Emergency Medicine Physician
  • Akron, OH
  • NPI 1265471148
  Medicare reassignment NPD
• Emergency Medicine Physicians of Tulsa County, LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1003098773
  Medicare reassignment NPD
• Grand Avenue Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1962913632
  Medicare reassignment NPD
• Mission Viejo Emergency Medical Associates

  • Emergency Medicine Physician
  • Mission Viejo, CA
  • NPI 1073542916
  Medicare reassignment NPD
• Mission Viejo Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Laguna Beach, CA
  • NPI 1134355597
  Medicare reassignment NPD
• Ridgeline Emergency Physicians Medical Group, Inc.

  • Emergency Medicine Physician
  • Northridge, CA
  • NPI 1972953230
  Medicare reassignment NPD
• Sonoma Valley Emergency Physicians Medical Group, Inc

  • Emergency Medicine Physician
  • Sonoma, CA
  • NPI 1710164629
  Medicare reassignment NPD
• Third Coast Emergency Physicians Southwest PA

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1497793475
  Medicare reassignment NPD
• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment NPD

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1821479221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N LEROY ST STE 203",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303803",
            "telephone_number": "330-231-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "address_2": "MEDICAL EDUCATION DEPT. 4626",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-6372",
            "fax_number": "810-606-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUSTACHE",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301108097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Essential Drugs LLC
• Sheleah Essett
• Khalid Mustafa Eteer, MD
• Stuart Etengoff, DO
• Maya Mackenzie Ettinger
• Emily Evans
• Francesca Marie Evans
• Lance Evans
• Taylor Hope Evans
• Evolve Therapy Collective LLC

• Emergency Medicine Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.