SAMUEL KIMBROUGH PA-C
NPI 1265134498
Physician Assistant in Edmond, OK

Active since March 21, 2023PECOS EnrolledAccepts Medicare Assignment
1701 RENAISSANCE BLVD STE 110, EDMOND, OK 73013(405) 844-4978 Get Directions Write a Review

NPPES record last updated: March 23, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Samuel Kimbrough Pa-c NPPES

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

SAMUEL KIMBROUGH PA-C (NPI 1265134498) is an individual physician assistant in Edmond, Oklahoma and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Oklahoma City, Inc, and is a graduate of University Of North Texas Hsc, College Of Osteopathic Med (2023).

NPPES Registry Identity

NPI1265134498
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSAMUEL KIMBROUGHCredential: PA-C
Location Address1701 RENAISSANCE BLVD STE 110Edmond, OK 73013-3084
Mailing Address301 N Walker Ave Apt 8101Oklahoma City, OK 73102-1871 · (580) 721-0409
Sole ProprietorNo
Medical School CMSUniversity Of North Texas Hsc, College Of Osteopathic MedGraduated 2023
Enumeration DateMarch 21, 2023
Last NPPES UpdateMarch 23, 2023
NPPES CertifiedMarch 23, 2023
NPI 1265134498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
1701 RENAISSANCE BLVD STE 110, Edmond, OK 73013

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

Samuel Kimbrough Pa-c 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 ID8123485364
PECOS Enrollment IDI20230605000376
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 13

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
146 services76 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
87 services76 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
84 services77 patients
Thyroid hormone, t3 measurement, free 84481
The T3 measurement, free, is a blood test that checks the level of a hormone called triiodothyronine. This hormone is produced by your thyroid, a small gland in your neck. It plays a key role in regulating your body's metabolism and energy use.
72 services71 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
65 services65 patients
Cyanocobalamin (vitamin b-12) level 82607
A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.
57 services52 patients

Hospital Affiliations CMS Care Compare 4

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

Mercy Hospital Oklahoma City, Inc

Acute Care Hospitals · Oklahoma City, OK
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number370013
Location4300 West Memorial RoadOklahoma City, OK 73120 · Oklahoma County
Emergency services Birthing friendly

Stillwater Medical Center

Acute Care Hospitals · Stillwater, OK
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number370049
Location1323 West 6th StreetStillwater, OK 74076 · Payne County
Emergency services Birthing friendly

Integris Health Edmond Hospital

Acute Care Hospitals · Edmond, OK
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number370236
Location4801 Integris ParkwayEdmond, OK 73034 · Oklahoma County
Emergency services Birthing friendly

Weatherford Regional Hospital, Inc Of Weatherford

Critical Access Hospitals · Weatherford, OK
OwnershipGovernment - Hospital District or Authority
CMS Certification Number371323
Location3701 E MainWeatherford, OK 73096 · Custer County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73013 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
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.68 – $132.40
Typical copayment $16.62 (range $4.17 – $33.10)
Most-billed visit code 99213
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 6

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

Nurse Practitioner (Family)
1701 RENAISSANCE BLVD STE 110
EDMOND, OK 73013
Nurse Practitioner (Family)
1701 RENAISSANCE BLVD STE 110
EDMOND, OK 73013
Physiological Laboratory
1701 RENAISSANCE BLVD STE 110
EDMOND, OK 73013
Nurse Practitioner
1701 RENAISSANCE BLVD STE 110
EDMOND, OK 73013
Specialist
1701 RENAISSANCE BLVD STE 110
EDMOND, OK 73013
Internal Medicine (Rheumatology)
1701 RENAISSANCE BLVD STE 110
EDMOND, OK 73013

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 Samuel Kimbrough's NPI number?

The NPI number for Samuel Kimbrough is 1265134498. It was assigned to this individual provider in the NPPES registry on March 21, 2023.

Where is Samuel Kimbrough located?

Samuel Kimbrough practices at 1701 Renaissance Blvd Ste 110, Edmond, OK 73013. The listed phone number is (405) 844-4978.

What is Samuel Kimbrough's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Samuel Kimbrough enrolled in Medicare?

Yes. Samuel Kimbrough 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 Samuel Kimbrough accept?

Health plans from Blue Cross and Blue Shield of Oklahoma, Medica, Mending Health and UnitedHealthcare list Samuel Kimbrough 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 Samuel Kimbrough affiliated with any hospitals?

According to CMS data, Samuel Kimbrough is affiliated with Mercy Hospital Oklahoma City, Inc, Stillwater Medical Center, Integris Health Edmond Hospital and Weatherford Regional Hospital, Inc Of Weatherford.

When was this NPI record last updated?

The NPPES record for Samuel Kimbrough was last updated on March 23, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.