Kimberly Lynn Underwood, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.002206 Issued in OH

Practice address

1934 Niles Cortland Rd NE Ste B
Warren, OH 44484-1055

Phone

(330) 841-4032

Fax

(330) 841-4381

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Health Physicians Youngstown Specialty Care LLCGroup PAC ID 3476950296, 463 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
• MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161
• MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
• East Liverpool City Hospital Hospital, East Liverpool, OH, CCN 360096

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kunderwood16960@direct.bsmhealth.org

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.

• Mercy Health Physicians Youngstown Specialty Care LLC

  • Surgery Physician
  • Youngstown, OH
  • NPI 1649892225

  Physician Assistant

  Medicare reassignment Care Compare group NPD (past)
• Mercy Health Physicians Youngstown, LLC

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1154636066

  Physician Assistant

  Medicare reassignment NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Boardman, OH
  • NPI 1386316107
  NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Physical Therapist
  • Warren, OH
  • NPI 1528736972
  NPD

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

• Mercy Health Youngstown LLC

  • Clinical Medical Laboratory
  • Warren, OH
  • NPI 1538233309

  Hospital

  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1548296106
  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Warren, OH
  • NPI 1629009964
  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982
  Care Compare affiliation
• Mercy Health Youngstown LLC

  • Clinical Medical Laboratory
  • Youngstown, OH
  • NPI 1831600295

  Hospital

  Care Compare affiliation
• The City Hospital Association

  • General Acute Care Hospital
  • East Liverpool, OH
  • NPI 1659375673
  Care Compare affiliation

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1891829560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 NILES CORTLAND RD NE STE B",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841055",
            "telephone_number": "330-841-4032",
            "fax_number": "330-841-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 NILES CORTLAND RD NE STE B",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841055",
            "telephone_number": "330-841-4032",
            "fax_number": "330-841-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084823",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Tye
• Gaye Tyhosky, RN
• U1St
• U1St Foundation
• John David Ulam, PT
• Mattie Vail, L.P.N.
• Alexis Valentino, CNP
• Elizabeth Vallas, PHARMD
• Valley Counseling
• Valley Counseling

• Physician Assistant in Warren, OH
• Providers in Warren, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.