Individual provider Active NPI

Kevin Wayne George, M.D.

  • Psychiatry Physician
  • Albany, NY
National Provider Identifier
1104816487
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
201439 Issued in NY
Practice address
30 Karner Rd
Unit 13385
Albany, NY 12212-7259
Phone
(518) 458-2481
Fax
(518) 489-4149
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 201439 NY Primary

Addresses

Primary practice location

30 Karner Rd
Unit 13385
Albany, NY 12212-7259

Mailing address

110 Wolf Rd
Suite 5
Colonie, NY 12205-1244
Phone (518) 458-2481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000581 NY Practitioner - Psychiatry 8628051158 Practice locations: Albany, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albany Medical College of Union University, 1994
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1510 Central Ave
Suite 375
Albany, NY 12205-5094
Phone (518) 458-2481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
201439NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Kevin George, Incorporated Psychiatry Current Accepting new patients

Locations

1510 Central Ave
Ste 375
Albany, NY 12205
Phone (518) 458-2481

30 Karner Rd
Unit 13385
Albany, NY 12212
Phone (518) 458-2481

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1104816487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WOLF RD",
            "address_2": "SUITE 5",
            "city": "COLONIE",
            "state": "NY",
            "postal_code": "122051244",
            "telephone_number": "518-458-2481",
            "fax_number": "518-489-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 KARNER RD",
            "address_2": "UNIT 13385",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122127259",
            "telephone_number": "518-458-2481",
            "fax_number": "518-489-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "KEVIN",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "201439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.