Individual provider Active NPI

Kimberly Rose Haynsworth, CNP

  • Adult Health Nurse Practitioner
  • Burlington, MA
National Provider Identifier
1992214340
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RB2289714 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-0001
Phone
(781) 744-8254
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RB2289714 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-0001

Mailing address

41 Mall Rd
Burlington, MA 01805-0001

Other names 1

  • Kimberly Rose Carey Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171010000152 MA Practitioner - Nurse Practitioner 9032484506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Winchester Hospital Hospital, Winchester, MA, CCN 220105
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Anna Jaques Hospital Hospital, Newburyport, MA, CCN 220029

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RB2289714MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc. CurrentSince Nov 13, 2017 Accepting new patients
Lahey Clinic, Inc CurrentSince Nov 13, 2017 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

Interoperability endpoints

  • Direct secure messaging: khaynsworth85082@direct.bilh.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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1992214340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNSWORTH",
        "first_name": "KIMBERLY",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RB2289714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CAREY",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.