Ms Kimberly Roberson, PA is a medicare enrolled "Physician Assistant" physician in Kenosha, Wisconsin. Her current practice location is
10400 75th St, Kenosha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(262) 948-5600.
Ms Kimberly Roberson is licensed to practice in Wisconsin (license number 1708) 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 1083666796.
Physician's Profile
| Full Name | Ms Kimberly Roberson |
|---|
| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 10400 75th St, Kenosha, Wisconsin |
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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: 1083666796
- Provider Enumeration Date: 05/17/2006
- Last Update Date: 01/15/2024
Medicare PECOS Information:
- PECOS PAC ID: 1153302989
- Enrollment ID: I20040527000671
Medical Identifiers
Medical identifiers for Ms Kimberly Roberson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1083666796 | NPI | - | NPPES |
| 007806261U | Other | | HUMANA |
| 41986600 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 1708 (Wisconsin) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | 1708 (Wisconsin) | Secondary |
| 363A00000X | Physician Assistant | 1708 (Wisconsin) | Primary |
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. Ms Kimberly Roberson 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 |
|---|
Ms Kimberly Roberson, PA
Po Box 735044,
Chicago, IL 60673-5044
Ph: (800) 326-2250 | Ms Kimberly Roberson, PA
10400 75th St,
Kenosha, WI 53142-7884
Ph: (262) 948-5600 |
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