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Physician Compare National (NPI:1811260508)

HEALTHCARE PROVIDER: KIMBERLY NEWBURY ANP-BC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1811260508
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2769709930
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20150327000366
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name NEWBURY
Individual professional last name
Provider First Name KIMBERLY
Individual professional first name
Provider Middle Name A
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 2011
Individual professional's medical school graduation year
Primary Specialty NURSE PRACTITIONER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name SEASONS MEDICAL GROUP OF MASSACHUSETTS PC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 1052564994
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 5
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 20 BURLINGTON MALL RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 450
Group Practice or individual's line 2 address
City BURLINGTON
Group Practice or individual's city
State MA
Group Practice or individual's state
Zip Code 018034129
Group Practice or individual's zip code (9 digits when available)
Phone Number 6174540200
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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