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

Q: 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.

Q: 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.

Q: When was this NPI record last updated?

The NPPES record for Kim Fallon was last updated on February 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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: October 18, 2026.

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

On this page

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

Phone(732) 349-5550

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

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Other Identifiers 1

Medicaid0192881NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Kim Fallon reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ocean Mental Health Services Inc

2.0 mi

Mental Health (Including Community Mental Health Center)

160 ATLANTIC CITY BLVD
Bayville, NJ 08721

Reassigned Medicare billing, New Jersey enrollment
69 clinicians in this Medicare group

NPI 1508884347 (732) 349-1977

Neuropsychology & Counseling Associates, LLC

13 mi

Clinical Neuropsychologist

1683 ROUTE 88, SUITE A
Brick, NJ 08724

Reassigned Medicare billing, New Jersey enrollment
34 clinicians in this Medicare group

NPI 1033213251 (732) 840-5266

Barnabas Health Medical Group, PC

60 mi

Specialist

95 OLD SHORT HILLS RD
West Orange, NJ 07052

Reassigned Medicare billing, New Jersey enrollment
757 clinicians in this Medicare group

NPI 1447206420 (888) 724-7123

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Quality

77.79

Promoting Interoperability

100

Improvement Activities

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.

CHRISTINE MCGOWAN LPC

Counselor (Professional)