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KIMBERLY PEACOCK DO
NPI 1235541665
Family Medicine in Cleveland, OH

Active since May 20, 2014PECOS Enrolled
15105 SAINT CLAIR AVE, CLEVELAND, OH 44110(216) 800-8020(216) 231-7920 Get Directions Write a Review

NPPES record last updated: January 11, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 11, 2023, May 18, 2018 (2 updates tracked since 2018).

About Kimberly Peacock Do NPPES

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

KIMBERLY PEACOCK DO (NPI 1235541665) is an individual family medicine provider in Cleveland, Ohio, licensed in Ohio (34.012512) and active in the NPI registry since May 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235541665
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKIMBERLY PEACOCKCredential: DO
Location Address15105 SAINT CLAIR AVECleveland, OH 44110-3719
Mailing Address15105 Saint Clair AveCleveland, OH 44110-3719 · (216) 800-8020 · Fax (216) 231-7920
Phone(216) 800-8020
Fax(216) 231-7920
Sole ProprietorYes
Enumeration DateMay 20, 2014
Last NPPES UpdateJanuary 11, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 11, 2023
✔ NPI 1235541665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 34.012512
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
15105 SAINT CLAIR AVE, Cleveland, OH 44110
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MedMutual.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Peacock Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

2

Medicare enrollment records show Kimberly Peacock reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northeast Ohio Neighborhood Health Services, Inc.
0.2 mi
Federally Qualified Health Center (FQHC)
15322 SAINT CLAIR AVE
Cleveland, OH 44110
  • Reassigned Medicare billing, Ohio enrollment
  • 40 clinicians in this Medicare group
NPI 1346272267 (216) 851-1500
Dedicated Ohio Holding LLC
1,080 mi
Internal Medicine
1395 NW 167TH ST
Miami, FL 33169
  • Reassigned Medicare billing, Ohio enrollment
  • 41 clinicians in this Medicare group
NPI 1922631019 (305) 628-6117

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44110 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Other Providers at the Same Location NPPES 7

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

DEDICATED OHIO HOLDING, LLC
Non-Pharmacy Dispensing Site
15105 SAINT CLAIR AVE
CLEVELAND, OH 44110
Cuyahoga County (216) 800-8020
MR. LAWRENCE OGOR IWELUNMOR PHARMACIST
Pharmacist
15105 SAINT CLAIR AVE
CLEVELAND, OH 44110
Cuyahoga County (216) 451-6260
MR. RAJA SEKHAR MACHANA
Pharmacist
15105 SAINT CLAIR AVE
CLEVELAND, OH 44110
Cuyahoga County (216) 451-6260
RAPHAELLE WOODS NURSE PRACTITIONER
Nurse Practitioner (Gerontology)
15105 SAINT CLAIR AVE
CLEVELAND, OH 44110
Cuyahoga County (216) 800-8020
MICHAEL STUHLER ANP
Nurse Practitioner (Adult Health)
15105 SAINT CLAIR AVE
CLEVELAND, OH 44110
Cuyahoga County (216) 800-8020
DANIELLE SAMONE BULLOCK-MOWOH MD
Family Medicine
15105 SAINT CLAIR AVE
CLEVELAND, OH 44110
Cuyahoga County (216) 800-8020
ALLISON REINARZ DO, MS
Family Medicine
15105 SAINT CLAIR AVE
CLEVELAND, OH 44110
Cuyahoga County (216) 800-8020

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 Kimberly Peacock's NPI number?

The NPI number for Kimberly Peacock is 1235541665. It was assigned to this individual provider in the NPPES registry on May 20, 2014.

Where is Kimberly Peacock located?

Kimberly Peacock practices at 15105 Saint Clair Ave, Cleveland, OH 44110. The listed phone number is (216) 800-8020.

What is Kimberly Peacock's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kimberly Peacock enrolled in Medicare?

Yes. Kimberly Peacock is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kimberly Peacock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Peacock reassigns Medicare benefits to 2 organizations: Northeast Ohio Neighborhood Health Services, Inc. (Cleveland, OH) and Dedicated Ohio Holding LLC (Miami, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Peacock's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Peacock accept?

Health plans from MedMutual list Kimberly Peacock 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.

When was this NPI record last updated?

The NPPES record for Kimberly Peacock was last updated on January 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.