Kimberly Ann Cooper, DO is a medicare enrolled "Pediatrics" physician in Greendale, Indiana. Her current practice location is
1640 Flossie Dr, Greendale, Indiana. You can reach out to her office (for appointments etc.) via phone at
(877) 670-7264.
Kimberly Ann Cooper is licensed to practice in Indiana (license number 01087306A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1386050524.
Physician's Profile
| Full Name | Kimberly Ann Cooper |
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| Gender | Female |
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| Speciality | Pediatrics |
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| Location | 1640 Flossie Dr, Greendale, Indiana |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1386050524
- Provider Enumeration Date: 07/09/2014
- Last Update Date: 05/18/2022
Medicare PECOS Information:
- PECOS PAC ID: 0749552180
- Enrollment ID: I20220520001080
Medical Identifiers
Medical identifiers for Kimberly Ann Cooper such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386050524 | NPI | - | NPPES |
| 2367501 | Medicaid | LA | |
| 0226978 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 34012820 (Ohio) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (Louisiana) | Secondary |
| 208000000X | Pediatrics | 01087306A (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Ann Cooper allows following entities to bill medicare on her behalf.
| Entity Name | Summit Medical Group, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508287640
PECOS PAC ID: 2163326240
Enrollment ID: O20040403000151 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Ann Cooper is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kimberly Ann Cooper, DO
5400 Dupont Circle Suite A,
Milford, OH 45150-2770
Ph: (513) 576-7700 | Kimberly Ann Cooper, DO
1640 Flossie Dr,
Greendale, IN 47025-8424
Ph: (877) 670-7264 |
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