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Individual provider Active NPI

Kimberly Anne Ifill, PA-C

  • Surgical Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1992755714
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9102435 Issued in FL
Practice address
1309 N. Flasler Dr.
West Palm Beach, FL 33401
Phone
(786) 218-0963
Fax
(561) 253-9175
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9102435 FL Primary

Addresses

Primary practice location

1309 N. Flasler Dr.
West Palm Beach, FL 33401

Mailing address

110 S K St #3
Lake Worth Beach, FL 33460
Phone (786) 218-0963

Other identifiers 1

IdentifierTypeStateIssuer
PA9102435OtherFLLICENSE

Other names 1

  • Miss Kimberly Anne Eschbach Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20051121000967 FL Practitioner - Physician Assistant 2163441049 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialtycare Surgical Assist, LLCGroup PAC ID 3274446497, 33 clinicians

Practice addresses (Care Compare)

20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (305) 682-7000

2201 45TH St
West Palm Beach, FL 33407-2047
Phone (561) 842-6141

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (561) 965-7300

Hospital & facility affiliations

  • Good Samaritan Medical Center Hospital, West Palm Beach, FL, CCN 100287
  • HCA Florida JFK Hospital Hospital, Atlantis, FL, CCN 100080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services II, LLC CurrentSince Jan 9, 2023 Accepting new patients
Tenet Florida Physician Services II, LLC Surgical CurrentSince Jan 9, 2023 Accepting new patients
Orthopedic Innovators Inc Past Accepting new patients
Speedix, Inc. Surgical Past Accepting new patients
Felix a Stanziola, MD, PA Past Accepting new patients

Locations

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

Organizations & group practices 6

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1992755714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S K ST #3",
            "city": "LAKE WORTH BEACH",
            "state": "FL",
            "postal_code": "33460",
            "telephone_number": "786-218-0963",
            "fax_number": "561-253-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 N. FLASLER DR.",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33401",
            "telephone_number": "786-218-0963",
            "fax_number": "561-253-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFILL",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-07-29",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9102435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA9102435",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "ESCHBACH",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.