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MS. KIMBERLY NICOLE FERGUSON PA-C
NPI 1629702733
Physician Assistant - Medical in Newark, DE

Active since July 13, 2022PECOS Enrolled
875 AAA BLVD STE C, NEWARK, DE 19713(302) 918-6400(302) 543-6002 Get Directions Write a Review

NPPES record last updated: July 13, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Kimberly Nicole Ferguson Pa-c NPPES

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

MS. KIMBERLY NICOLE FERGUSON PA-C (NPI 1629702733) is an individual medical provider in Newark, Delaware, licensed in Delaware (C5-0011757) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1629702733
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMS. KIMBERLY NICOLE FERGUSONCredential: PA-C
Location Address875 AAA BLVD STE CNewark, DE 19713-3624
Mailing Address875 Aaa Blvd Ste CNewark, DE 19713-3624 · (302) 918-6400 · Fax (302) 543-6002
Phone(302) 918-6400
Fax(302) 543-6002
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 13, 2022
NPPES CertifiedJuly 9, 2022
✔ NPI 1629702733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in DE · C5-0011757
875 AAA BLVD STE C, Newark, DE 19713
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kimberly Nicole Ferguson Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID749757136
PECOS Enrollment IDI20260422003236
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.

Other Providers at the Same Location NPPES 4

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

JACLYN MADDEN NP
Nurse Practitioner (Pediatrics)
875 AAA BLVD STE C
NEWARK, DE 19713
New Castle County (302) 918-6400
SONIA SHASTRY DO
Pediatrics
875 AAA BLVD STE C
NEWARK, DE 19713
New Castle County (302) 918-6400
MADISON E GOUDY PA-C, MSPAS
Physician Assistant (Medical)
875 AAA BLVD STE C
NEWARK, DE 19713
New Castle County (302) 918-6400
ADVOCARE, LLC
Pediatrics
875 AAA BLVD STE C
NEWARK, DE 19713
New Castle County (302) 918-6400

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 Ferguson's NPI number?

The NPI number for Kimberly Ferguson is 1629702733. It was assigned to this individual provider in the NPPES registry on July 13, 2022.

Where is Kimberly Ferguson located?

Kimberly Ferguson practices at 875 Aaa Blvd Ste C, Newark, DE 19713. The listed phone number is (302) 918-6400.

What is Kimberly Ferguson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kimberly Ferguson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kimberly Ferguson was last updated on July 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.