Individual provider Active NPI

Howard Myles Kimmel, DPM

  • Podiatrist
  • Brookpark, OH
National Provider Identifier
1124055918
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002841 Issued in OH
Practice address
14401 Snow Rd
Brookpark, OH 44142-2583
Phone
(216) 267-0304
Fax
(216) 267-1077
NPI assigned
Jun 27, 2006
Last updated
Feb 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36002841 OH Primary

Addresses

Primary practice location

14401 Snow Rd
Brookpark, OH 44142-2583

Mailing address

14401 Snow Rd
Brookpark, OH 44142-2583
Phone (216) 267-0304

Other identifiers 2

IdentifierTypeStateIssuer
0942323MedicaidOH
480026423OtherOHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325001353 OH Practitioner - Podiatry 0143112177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14401 Snow Rd
Suite 102
Brookpark, OH 44142-2583
Phone (216) 267-0304

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue101
Removal of skin lesions27
Removal of nail tissue258
Removal or shaving of skin growth72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36002841OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Buckeye Foot Care Podiatrist CurrentSince Apr 1, 1994 Accepting new patients
Circle Health Services CurrentSince Jan 26, 2019 Accepting new patients
Circle Health Services CurrentSince Jan 26, 2019 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

3619 Park East Dr
Ste 110
Beachwood, OH 44122
Phone (216) 464-4646

14401 Snow Rd
Ste 102
Brookpark, OH 44142
Phone (216) 267-0304

12201 Euclid Ave
Cleveland, OH 44106
Phone (216) 373-2846

5105 Som Center Rd
Ste 102
Willoughby, OH 44094
Phone (216) 267-0304

Interoperability endpoints

  • Direct secure messaging: hkimmel32915@direct.ccf.org
  • Direct secure messaging: hkimmel37515@ehrdirect.uhhospitals.org

Organizations & group practices 5

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1124055918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14401 SNOW RD",
            "city": "BROOKPARK",
            "state": "OH",
            "postal_code": "441422583",
            "telephone_number": "216-267-0304",
            "fax_number": "216-267-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14401 SNOW RD",
            "city": "BROOKPARK",
            "state": "OH",
            "postal_code": "441422583",
            "telephone_number": "216-267-0304",
            "fax_number": "216-267-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "HOWARD",
        "middle_name": "MYLES",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0942323",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480026423",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookpark, OH

Sources for this page

Verify at the official NPI Registry.