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KELLY ISABEL KAMIMURA-NISHIMURA M.D.
NPI 1639481096
Pediatrics - Developmental - Behavioral Pediatrics in Cincinnati, OH

Active since July 13, 2010PECOS Enrolled
3430 BURNET AVE., MLC 4002, CINCINNATI, OH 45229(513) 636-4611(513) 636-3800 Get Directions Write a Review

NPPES record last updated: October 28, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kelly Isabel Kamimura-nishimura M.d. NPPES

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

KELLY ISABEL KAMIMURA-NISHIMURA M.D. (NPI 1639481096) is an individual developmental - behavioral pediatrics provider in Cincinnati, Ohio, licensed in Ohio (35.120974) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639481096
Entity TypeIndividualFemale
Primary Taxonomy2080P0006X
Provider Legal NameKELLY ISABEL KAMIMURA-NISHIMURACredential: M.D.
Location Address3430 BURNET AVE., MLC 4002Cincinnati, OH 45229-3026
Mailing Address3430 Burnet Ave., Mlc 4002Cincinnati, OH 45229-3026 · (513) 636-4611 · Fax (513) 636-3800
Phone(513) 636-4611
Fax(513) 636-3800
Sole ProprietorNo
Enumeration DateJuly 13, 2010
Last NPPES UpdateOctober 28, 2016
✔ NPI 1639481096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians
Taxonomy Code2080P0006X
License✔ Licensed in OH · 35.120974
Definition
A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
3430 BURNET AVE., Cincinnati, OH 45229
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, 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)

Kelly Isabel Kamimura-nishimura M.d. 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 Reassignment

Medicare enrollment records show Kelly Kamimura-nishimura reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Children's Hospital Medical Center
0.2 mi
Pediatrics
3333 BURNET AVENUE
Cincinnati, OH 45229
  • Reassigned Medicare billing, Ohio enrollment
  • 2,080 clinicians in this Medicare group
NPI 1609915784 (513) 636-4225

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

Other Providers at the Same Location NPPES 2

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

DR. JENNIFER VANNEST PHD, MA
Speech-Language Pathologist
3430 BURNET AVE., ML 4011
CINCINNATI, OH 45229
Hamilton County (513) 636-6959
DR. PATRICIA MARY MANNING-COURTNEY M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3430 BURNET AVE., MLC 4002
CINCINNATI, OH 45229
Hamilton County (513) 363-4611

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 Kelly Kamimura-nishimura's NPI number?

The NPI number for Kelly Kamimura-nishimura is 1639481096. It was assigned to this individual provider in the NPPES registry on July 13, 2010.

Where is Kelly Kamimura-nishimura located?

Kelly Kamimura-nishimura practices at 3430 Burnet Ave. Mlc 4002, Cincinnati, OH 45229. The listed phone number is (513) 636-4611.

What is Kelly Kamimura-nishimura's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Is Kelly Kamimura-nishimura enrolled in Medicare?

Yes. Kelly Kamimura-nishimura is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Kamimura-nishimura's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Kamimura-nishimura reassigns Medicare benefits to Children's Hospital Medical Center (Cincinnati, OH). The 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 Kelly Kamimura-nishimura's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Kamimura-nishimura accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and MedMutual list Kelly Kamimura-nishimura 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 Kelly Kamimura-nishimura was last updated on October 28, 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.