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KIMBERLY L. PLOEHN M.D.
NPI 1528075199
Family Medicine in Crown Point, IN

Active since August 03, 2006PECOS EnrolledAccepts Medicare Assignment
10215 BROADWAY FL 1, CROWN POINT, IN 46307(219) 661-6098(219) 703-6812 Get Directions Write a Review

NPPES record last updated: November 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kimberly L. Ploehn M.d. NPPES

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

KIMBERLY L. PLOEHN M.D. (NPI 1528075199) is an individual family medicine provider in Crown Point, Indiana, licensed in Indiana (01094884A) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Community Hospital, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1528075199
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKIMBERLY L. PLOEHNCredential: M.D.
Location Address10215 BROADWAY FL 1Crown Point, IN 46307-8001
Mailing Address8558 BroadwayMerrillville, IN 46410-7032 · (219) 392-7084 · Fax (219) 703-6854
Phone(219) 661-6098
Fax(219) 703-6812
Sole ProprietorYes
Medical School CMSMichigan State University College Of Human MedicineGraduated 1991
Enumeration DateAugust 3, 2006
Last NPPES UpdateNovember 1, 2024
NPPES CertifiedNovember 1, 2024
✔ NPI 1528075199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01094884A
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.
10215 BROADWAY FL 1, Crown Point, IN 46307
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Other Names 1

Former Name (1)Kimberly L Martin

Secondary Practice Locations 4

Location 110240 Calumet AveMunster, IN 46321-2880 · Phone (219) 703-2420 · Fax (219) 703-6765
Location 29660 Wicker AveSaint John, IN 46373-9487 · Phone (219) 365-1177 · Fax (219) 703-6662
Location 37651 Harvest DrSchererville, IN 46375-3476 · Phone (219) 322-5723 · Fax (219) 440-5227
Location 41451 Morthland Dr Ste DValparaiso, IN 46385-6360 · Phone (219) 286-3880 · Fax (219) 286-3881

Other Identifiers 3

Medicaid300096697IN
Medicaid3084194MI
Other1104457857IN · Anthem

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

Kimberly L. Ploehn M.d. 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 ID5698737088
PECOS Enrollment IDI20240926001275
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 Ploehn reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Community Care Network Inc
7.1 mi
Family Medicine
9660 WICKER AVE
St John, IN 46373
  • Reassigned Medicare billing, Indiana enrollment
  • 607 clinicians in this Medicare group
NPI 1457610487 (219) 365-7620
Edward W Sparrow Hospital Association
158 mi
Pain Medicine
205 S DEXTER ST
Ionia, MI 48846
  • Reassigned Medicare billing, Michigan enrollment
  • 916 clinicians in this Medicare group
NPI 1891486205 (616) 527-0558

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 6

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 low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
156 services151 patients
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.
75 services70 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428
This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
33 services33 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
23 services22 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
21 services21 patients
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880
A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Community Hospital

Acute Care Hospitals · Munster, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150125
Location901 Macarthur BlvdMunster, IN 46321 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46307 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
32%404 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
35%549 patients2/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Ploehn's NPI number?

The NPI number for Kimberly Ploehn is 1528075199. It was assigned to this individual provider in the NPPES registry on August 3, 2006. The provider is also known as Kimberly L Martin.

Where is Kimberly Ploehn located?

Kimberly Ploehn practices at 10215 Broadway Fl 1, Crown Point, IN 46307. The listed phone number is (219) 661-6098.

What is Kimberly Ploehn's specialty?

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

Is Kimberly Ploehn enrolled in Medicare?

Yes. Kimberly Ploehn 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.

Which organizations bill Medicare for Kimberly Ploehn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Ploehn reassigns Medicare benefits to 2 organizations: Community Care Network Inc (St John, IN) and Edward W Sparrow Hospital Association (Ionia, MI). 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 Ploehn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Kimberly Ploehn affiliated with any hospitals?

According to CMS data, Kimberly Ploehn is affiliated with Community Hospital.

When was this NPI record last updated?

The NPPES record for Kimberly Ploehn was last updated on November 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.