Jessica Kimball (NPI# 1326421504, PAC ID# 3779880257) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1326421504 |
| PAC ID by PECOS | 3779880257 |
| Professional Enrollment ID | I20160329000325 |
| Full Name | Jessica Kimball |
| Organization Legal Name | LAKE ONTARIO PROMPT MEDICAL CARE, PLLC |
| Address |
300 State Route 104 2 Oswego NY 13126-2956 |
| Phone Number | 3153420030 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2264659101 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330218 | OSWEGO HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 300 State Route 104 2, Oswego, NY 13126-2956 | 3153420030 | LAKE ONTARIO PROMPT MEDICAL CARE, PLLC |
| 300 State Route 104 E, Oswego, NY 13126-2956 | 3153420030 | DR. PADMA RAM MEDICAL SERVICES LLC |
| Organization Legal Name | LAKE ONTARIO PROMPT MEDICAL CARE, PLLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Padma Ram | Internal Medicine | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Emily Megan Crandell | Physician Assistant | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Bruce T Pecorella | Physician Assistant | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Justin Raymond Beebe | Nurse Practitioner | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Katrina L Bonnie | Nurse Practitioner | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Street Address |
300 STATE ROUTE 104 2 |
| City | OSWEGO |
| State | NY |
| Zip | 13126-2956 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Padma Ram | Internal Medicine | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Emily Megan Crandell | Physician Assistant | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Bruce T Pecorella | Physician Assistant | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Justin Raymond Beebe | Nurse Practitioner | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Katrina L Bonnie | Nurse Practitioner | Lake Ontario Prompt Medical Care, Pllc | 300 State Route 104 2, Oswego, NY 13126-2956 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ivan G Proano | Ophthalmology | Ivan G Proano Md Pllc | 15 Bronson St, Oswego, NY 13126-1004 |
| Matthew J Liepke | Internal Medicine | Port City Family Medicine PC Inc | 33 E Schuyler St, Oswego, NY 13126-1161 |
| Corliss A Varnum | Family Medicine | Port City Family Medicine PC Inc | 33 E Schuyler St, Oswego, NY 13126-1161 |
| Joan Newell | Internal Medicine | Port City Family Medicine PC Inc | 33 E Schuyler St, Oswego, NY 13126-1161 |
| Christina M Liepke | Family Medicine | Port City Family Medicine PC Inc | 33 E Schuyler St, Oswego, NY 13126-1161 |
| Theresa Check | Certified Nurse Midwife (cnm) | Oswego County Ob-gyn PC | 42 Montcalm St, Oswego, NY 13126-1321 |
| Raj K Mahajan | Obstetrics/gynecology | Oswego County Ob-gyn PC | 42 Montcalm St, Oswego, NY 13126-1321 |
| Megan Rae Irland | Physician Assistant | Oswego County Ob-gyn PC | 42 Montcalm St, Oswego, NY 13126-1321 |
| Daniel G Coty | Obstetrics/gynecology | Oswego County Ob-gyn PC | 42 Montcalm St, Oswego, NY 13126-1321 |
| Ayesha Lauren Turner | Obstetrics/gynecology | Oswego County Ob-gyn PC | 42 Montcalm St, Oswego, NY 13126-1321 |
| Find all physicians in zip 13126 | |||
| City | OSWEGO |
| Zip Code | 13126 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | OSWEGO + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.