Individual provider Active NPI

Kevin Williams, M.D.

Family Medicine Physician
New York, NY

National Provider Identifier

1104156488

Registry record updated Feb 11, 2026

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
NPI Registry JSON
Other providers in New York, NY
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Family Medicine PhysicianTaxonomy code 207Q00000X
License: ME169225 Issued in FL
Practice address: 26 Broadway Ste 934
New York, NY 10004-1717
Phone: (561) 421-5036
Fax: (561) 421-5364
NPI assigned: Jan 8, 2010
Sex: Male
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 15

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	04-51634	KS
Family Medicine Physician	207Q00000X	43785	OK
Family Medicine Physician	207Q00000X	7171082	ID
Family Medicine Physician	207Q00000X	01098046A	IN
Family Medicine Physician	207Q00000X	2025-04055	NC
Family Medicine Physician	207Q00000X	4301515453	MI
Family Medicine Physician	207Q00000X	DR.0076248	CO
Family Medicine Physician	207Q00000X	MD-56100	IA
Family Medicine Physician	207Q00000X	328118	NY
Family Medicine Physician	207Q00000X	19077A	WY
Family Medicine Physician	207Q00000X	25MA07662800	NJ
Family Medicine Physician	207Q00000X	21369	ND
Family Medicine Physician	207Q00000X	C-204468	CA
Family Medicine Physician	207Q00000X	C1-0028866	DE
Family Medicine Physician	207Q00000X	ME169225	FL	Primary

Addresses

Primary practice location

26 Broadway Ste 934
New York, NY 10004-1717

Mailing address

5 Greentree Center
Suite 117
Marlton, NJ 08053
Phone (561) 421-5036

Other practice location 1

321 S Boston Ave Ste 300
Tulsa, OK 74103-3311
Phone (561) 421-5036

Other practice location 2

401 E Jackson St Ste 2340
Tampa, FL 33602-5226
Phone (561) 421-5036

Other practice location 3

5717 21st Ave W
Bradenton, FL 34209
Phone (561) 421-5036

Other practice location 4

13475 Atlantic Blvd Ste 8
Jacksonville, FL 32225-3290
Phone (561) 421-5036

Other practice location 5

525 Route 73 N Ste 117
Marlton, NJ 08053-3422
Phone (561) 421-5036

Other practice location 6

9350 Wilshire Blvd Ste 203
Beverly Hills, CA 90212-3204
Phone (561) 421-5036

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: No
Medical equipment: Yes
Home health: No
Power mobility devices: Yes
Hospice: No

Green means eligible to order or refer.

National Provider Directory

Medicare enrollment (NPD): Enrolled
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
C-204468	CA	MD	Family Medicine Physician
DR.0076248	CO	MD	Family Medicine Physician
C1-0028866	DE	MD	Family Medicine Physician
ME169225	FL	MD	Family Medicine Physician
MD-56100	IA	MD	Family Medicine Physician
7171082	ID	MD	Family Medicine Physician
01098046A	IN	MD	Family Medicine Physician
04-51634	KS	MD	Family Medicine Physician
4301515453	MI	MD	Family Medicine Physician
2025-04055	NC	MD	Family Medicine Physician
21369	ND	MD	Family Medicine Physician
25MA07662800	NJ	MD	Family Medicine Physician
328118	NY	MD	Family Medicine Physician
43785	OK	MD	Family Medicine Physician
19077A	WY	MD	Family Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1104156488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GREENTREE CENTER",
            "address_2": "SUITE 117",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "561-421-5036",
            "fax_number": "561-421-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BROADWAY STE 934",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041717",
            "telephone_number": "561-421-5036",
            "fax_number": "561-421-5364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 S Boston Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741033311",
            "country_code": "US",
            "telephone_number": "561-421-5036",
            "fax_number": "561-421-5364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 E Jackson St Ste 2340",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336025226",
            "country_code": "US",
            "telephone_number": "561-421-5036",
            "fax_number": "561-421-5364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5717 21st Ave W",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "34209",
            "country_code": "US",
            "telephone_number": "561-421-5036",
            "fax_number": "561-421-5364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13475 Atlantic Blvd Ste 8",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322253290",
            "country_code": "US",
            "telephone_number": "561-421-5036",
            "fax_number": "561-421-5364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Route 73 N Ste 117",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080533422",
            "country_code": "US",
            "telephone_number": "561-421-5036",
            "fax_number": "561-421-5364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9350 Wilshire Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902123204",
            "country_code": "US",
            "telephone_number": "561-421-5036",
            "fax_number": "561-421-5364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-08",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-51634",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "43785",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "7171082",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01098046A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2025-04055",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301515453",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0076248",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-56100",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "328118",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "19077A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07662800",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "21369",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C-204468",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C1-0028866",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME169225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.