Kimberly Blum, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9109154 Issued in FL

Practice address

1651 SE Tiffany Ave
Port St Lucie, FL 34952-7564

Phone

(772) 223-4978

Fax

(772) 398-1815

NPI assigned

Nov 14, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Martin Memorial Medical Center IncGroup PAC ID 2961300611, 514 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Merit-based Incentive Payment System (MIPS)

Final score

92.26 of 100Reported as apm

Quality

80.2

Promoting interoperability

99.24

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: kblum2496271@direct.ccf.org

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.

• Martin Memorial Medical Center Inc

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  Medicare reassignment Care Compare group
• Euclid Hospital Cleveland Clinic Health System

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Martin Memorial Medical Center Inc

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  Care Compare affiliation

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

{
    "created_epoch": "1447459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1972977973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527564",
            "telephone_number": "772-223-4978",
            "fax_number": "772-398-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527564",
            "telephone_number": "772-223-4978",
            "fax_number": "772-398-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "KIMBERLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-14",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9109154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Blomer, MD
• Blooming Minds ABA Services LLC.
• Blossom Homes LLC
• Blue Dolphin Medical Services LLC
• Blue Water Anesthesia Services
• Monique Blum, RD/LDN
• Scott Jeffry Blutstein, DPM
• BNG Enterprises, Inc.
• Tammy Rena Boatright
• Megan Bock

• Physician Assistant in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.