NPIMap

Individual provider Active NPI

Kirstie Zimmerman, PAC

  • Physician Assistant
  • Gig Harbor, WA
National Provider Identifier
1952864043
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61261823 Issued in WA
Practice address
11511 Canterwood Blvd Ste 205
Gig Harbor, WA 98332-5818
Phone
(253) 530-2663
Fax
(253) 530-2675
NPI assigned
Apr 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61261823 WA Primary

Addresses

Primary practice location

11511 Canterwood Blvd Ste 205
Gig Harbor, WA 98332-5818

Mailing address

11511 Canterwood Blvd Ste 205
Gig Harbor, WA 98332-5818
Phone (253) 530-2663

Other identifiers 1

IdentifierTypeStateIssuer
2206634MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kzimmerman325230@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220531000028 WA Practitioner - Physician Assistant 3971838806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11511 Canterwood Blvd
Gig Harbor, WA 98332-5813

11511 Canterwood Blvd NW
Suite 100
Gig Harbor, WA 98332-5813
Phone (253) 627-1244

11567 Canterwood Blvd NW
Gig Harbor, WA 98332-5812
Phone (253) 426-6341

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

  • CHI Franciscan Health at Home Home health agency, University Place, WA, CCN 507124
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince May 16, 2022 Accepting new patients
Franciscan Medical Group CurrentSince May 16, 2022 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Locations

11511 Canterwood Blvd
Ste 205
Gig Harbor, WA 98332
Phone (253) 530-2663

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

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 8

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": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1952864043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD STE 205",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325818",
            "telephone_number": "253-530-2663",
            "fax_number": "253-530-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD STE 205",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325818",
            "telephone_number": "253-530-2663",
            "fax_number": "253-530-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "KIRSTIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-07",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61261823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2206634",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kzimmerman325230@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11511 Canterwood Blvd Ste 205",
            "city": "Gig Harbor",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983325818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.