Individual provider Active NPI

Kimberly Anne Palmieri, M.D.

  • Pediatrics Physician
  • Madison, CT
National Provider Identifier
1932408291
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
55005 Issued in CT
Practice address
1110 Durham Rd
Madison, CT 06443-1858
Phone
(203) 421-3600
NPI assigned
Mar 24, 2011
Last updated
Jan 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 55005 CT Primary

Addresses

Primary practice location

1110 Durham Rd
Madison, CT 06443-1858

Mailing address

3401 Civic Center Blvd
Division of Child and Adolescent Psychiatry
Philadelphia, PA 19104-4319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160627002041 CT Practitioner - Pediatric Medicine 4688965304 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55005CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Pediatrics CurrentSince May 2, 2016 Accepting new patients
Shoreline Pediatrics & Adolescent Medicine, P.C. PastSince Jan 12, 2020 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

495 Route 184
Ste 120
Groton, CT 06340
Phone (860) 449-8882

1110 Durham Rd
Madison, CT 06443
Phone (203) 421-3600

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: kimberly.palmieri.npi1932408291.phpct@direct.optumcare.masshiway.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1932408291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF CHILD AND ADOLESCENT PSYCHIATRY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 DURHAM RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064431858",
            "telephone_number": "203-421-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMIERI",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "55005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

Verify at the official NPI Registry.