KIMBERLY COOPER (PA-C) – Medical Physician Assistant, NPI 1063202851

KIMBERLY COOPER (PA-C) is a healthcare provider. based in Clearwater, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 9120216 (FL). The NPI Number for KIMBERLY COOPER (PA-C) is 1063202851

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
KIMBERLY COOPER (PA-C)
NPI
1063202851
Phone
(239) 404-7601
Address
455 PINELLAS ST STE 400
Enumeration Date
7 May 2025
Last Update Date
3 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
72744519923222
Graduation Year
2025 (1 year ago)
PAC ID
0648783373
Group Practice PAC ID
9436108099
Professional Enrollment ID
I20250626003873
Address ID
FL337563356CL455XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for KIMBERLY COOPER (PA-C)

  • 455 PINELLAS ST STE 400

    CLEARWATER, FL 337563356

    Phone: (239) 404-7601

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250626003873IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33756)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436108099View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)FL
Nurse PractitionerFL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)FL
Cardiovascular Disease (Cardiology)FL
Cardiovascular Disease (Cardiology)FL
Nurse PractitionerFL
Cardiovascular Disease (Cardiology), Internal MedicineFL
Interventional CardiologyFL
Cardiovascular Disease (Cardiology), Internal MedicineFL
Interventional Cardiology, Cardiovascular Disease (Cardiology)FL

Reviews

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Frequently asked questions

Can I use this page to confirm KIMBERLY COOPER (PA-C)'s NPI?
Yes. KIMBERLY COOPER (PA-C) is listed with NPI 1063202851 in the public NPI dataset.
Is KIMBERLY COOPER (PA-C) still practicing?
KIMBERLY COOPER (PA-C) is currently listed as active in the public NPI registry.
What is KIMBERLY COOPER (PA-C) best known for clinically?
Directory data describes KIMBERLY COOPER (PA-C) with Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for KIMBERLY COOPER (PA-C)?
KIMBERLY COOPER (PA-C)'s geographic hint is Clearwater, Florida in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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