NPIMap

Individual provider Active NPI

Kimberly Marie Kuphal, PA

  • Surgical Physician Assistant
  • Wausau, WI
National Provider Identifier
1922536218
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1142574 Issued in WI
Practice address
425 Pine Ridge Blvd Ste 209
Wausau, WI 54401-4123
Phone
(715) 847-0400
NPI assigned
May 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1142574 WI Primary

Addresses

Primary practice location

425 Pine Ridge Blvd Ste 209
Wausau, WI 54401-4123

Mailing address

425 Pine Ridge Blvd Ste 209
Wausau, WI 54401-4123
Phone (715) 847-0400

Other practice location 1

333 Pine Ridge Blvd
Wausau, WI 54401-4102
Phone (715) 847-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20170829003562 WI Practitioner - Physician Assistant 1557634433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Medical Group, Inc.Group PAC ID 1052223625, 272 clinicians

Practice addresses (Care Compare)

4005 Community Ctr Dr
Weston, WI 54476-4139
Phone (715) 241-5400

425 Pine Ridge Blvd
Wausau, WI 54401-4123

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030
  • Aspirus Riverview Hospital & Clinics Inc Hospital, Wisconsin Rapids, WI, CCN 520033

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
77.62
Promoting interoperability
100
Improvement activities
40
Cost
78.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1142574WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Medical Group, Inc. CurrentSince Aug 1, 2017 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Aug 1, 2017 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

425 Pine Ridge Blvd
Ste 209
Wausau, WI 54401
Phone (715) 845-4606

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Interoperability endpoints

  • Direct secure messaging: kkuphal127886@direct.aspirus.org

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.

Hospital & facility affiliations 12

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": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922536218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD STE 209",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-847-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD STE 209",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-847-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Pine Ridge Blvd",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544014102",
            "country_code": "US",
            "telephone_number": "715-847-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUPHAL",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1142574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.