KIM M FALLON APN
NPI 1013005289
Nurse Practitioner - Psychiatric/Mental Health in Bayville, NJ

Active since October 11, 2006PECOS EnrolledAccepts Medicare Assignment
93.71/100
CMS Quality Rating
160 ROUTE 9, BAYVILLE, NJ 08721(732) 349-5550(732) 505-1517 Get Directions Write a Review

NPPES record last updated: February 11, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 11, 2016, Feb 3, 2016, Jan 25, 2016 (3 updates tracked since 2016).

About Kim M Fallon Apn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM M FALLON APN (NPI 1013005289) is an individual psychiatric/mental health provider in Bayville, New Jersey, licensed in New Jersey (26NJ00062300) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1013005289
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKIM M FALLONCredential: APN
Location Address160 ROUTE 9Bayville, NJ 08721-1229
Mailing Address160 Route 9Bayville, NJ 08721-1229 · (732) 349-5550 · Fax (732) 505-1517
Fax(732) 505-1517
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateOctober 11, 2006
Last NPPES UpdateFebruary 11, 20163 updates tracked since enumeration
NPI 1013005289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in NJ · 26NJ00062300
160 ROUTE 9, Bayville, NJ 08721

Other Identifiers 1

Medicaid0192881NJ

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kim M Fallon Apn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002850849
PECOS Enrollment IDI20050614000047
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
238 services229 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
132 services83 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
122 services92 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Community Medical Center

Acute Care Hospitals · Toms River, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310041
Location99 Rt 37 WestToms River, NJ 08755 · Ocean County
Emergency services Birthing friendly

Monmouth Medical Center-Southern Campus

Acute Care Hospitals · Lakewood, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310084
Location600 River AveLakewood, NJ 08701 · Ocean County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08721 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.90 typical visit price
range $61.59 – $185.05
Typical copayment $23.72 (range $15.39 – $46.26)
Most-billed visit code 99203
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.79
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
160 ROUTE 9
BAYVILLE, NJ 08721
Social Worker (Clinical)
160 ROUTE 9
BAYVILLE, NJ 08721
Social Worker (Clinical)
160 ROUTE 9
BAYVILLE, NJ 08721
Counselor (Professional)
160 ROUTE 9
BAYVILLE, NJ 08721
Social Worker (Clinical)
160 ROUTE 9
BAYVILLE, NJ 08721
Counselor (Mental Health)
160 ROUTE 9
BAYVILLE, NJ 08721
Counselor (Professional)
160 ROUTE 9
BAYVILLE, NJ 08721
Social Worker (Clinical)
160 ROUTE 9
BAYVILLE, NJ 08721

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Fallon's NPI number?

The NPI number for Kim Fallon is 1013005289. It was assigned to this individual provider in the NPPES registry on October 11, 2006.

Where is Kim Fallon located?

Kim Fallon practices at 160 Route 9, Bayville, NJ 08721. The listed phone number is (732) 349-5550.

What is Kim Fallon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kim Fallon enrolled in Medicare?

Yes. Kim Fallon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kim Fallon accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Kim Fallon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kim Fallon affiliated with any hospitals?

According to CMS data, Kim Fallon is affiliated with Community Medical Center and Monmouth Medical Center-Southern Campus.

When was this NPI record last updated?

The NPPES record for Kim Fallon was last updated on February 11, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.