NPIMap

Individual provider Active NPI

Kimberly S Hovsepian, PA

  • Medical Physician Assistant
  • Newkirk, OK
National Provider Identifier
1891872933
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1500651 Issued in KS
Practice address
3151 E River Rd
Newkirk, OK 74647-7517
Phone
(580) 362-1039
Fax
(580) 362-2988
NPI assigned
Nov 1, 2006
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1500651 KS Primary

Addresses

Primary practice location

3151 E River Rd
Newkirk, OK 74647-7517

Mailing address

3151 E River Rd
PO Box 474
Newkirk, OK 74647-7517
Phone (580) 362-1039

Other identifiers 2

IdentifierTypeStateIssuer
TEZKKLZR7MOtherOKMEDICARE PTAN
100321990AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160121000293 TX Practitioner - Physician Assistant 3779481502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaw NationGroup PAC ID 4486542552, 4 clinicians

Practice addresses (Care Compare)

3151 E River Rd
Kanza Health Clinic
Newkirk, OK 74647-7517
Phone (580) 362-1039

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1731COMDClinical Psychologist
1749OKMDPhysical Therapy Assistant
1500651KSMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Center Past Accepting new patients
Ascension Via Christi Rehabilitation Hospital, Inc. PastSince Apr 1, 2008 Accepting new patients
Integris Health Ponca City Hospital Inc Past Accepting new patients
Kansas Imaging Consultants, PA Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1891872933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 E RIVER RD",
            "address_2": "PO BOX 474",
            "city": "NEWKIRK",
            "state": "OK",
            "postal_code": "746477517",
            "telephone_number": "580-362-1039",
            "fax_number": "580-362-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 E RIVER RD",
            "city": "NEWKIRK",
            "state": "OK",
            "postal_code": "746477517",
            "telephone_number": "580-362-1039",
            "fax_number": "580-362-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOVSEPIAN",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "1500651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "TEZKKLZR7M",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100321990A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newkirk, OK

Sources for this page

Verify at the official NPI Registry.