Individual provider Active NPI

Kimberly Bombaci, M.D.

  • Family Medicine Physician
  • Worcester, MA
National Provider Identifier
1932420676
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
256678 Issued in MA
Practice address
279 Lincoln St
Worcester, MA 01605-2120
Phone
(508) 334-8830
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 256678 MA Primary

Addresses

Primary practice location

279 Lincoln St
Worcester, MA 01605-2120

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kbombaci22240@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20130924000747 MA Practitioner - Family Practice 7911141320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

279 Lincoln St
Worcester, MA 01605-2120
Phone (508) 334-8830

281 Lincoln St
Worcester, MA 01605-2138
Phone (508) 334-1000

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Aug 5, 2013 Accepting new patients
Umass Memorial Medical Group Inc Family Medicine CurrentSince Aug 5, 2013 Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients

Locations

279 Lincoln St
Worcester, MA 01605
Phone (508) 334-2537

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: kbombaci22240@umassmemorial.direct-ci.com

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 2

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1932420676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052120",
            "telephone_number": "508-334-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBACI",
        "first_name": "KIMBERLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "256678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbombaci22240@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "279 Lincoln St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "279 Lincoln St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.