NPIMap

Individual provider Active NPI

Preston James Kick, D.O.

  • Family Medicine Physician
  • Media, PA
National Provider Identifier
1164806048
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS022514 Issued in PA
Practice address
605 West State Street
Media, PA 19063-2620
Phone
(301) 752-8529
NPI assigned
Jul 10, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS022514 PA Primary

Addresses

Primary practice location

605 West State Street
Media, PA 19063-2620

Mailing address

605 West State Street
2ND Floor
Media, PA 19063-2620
Phone (301) 752-8529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180416001516 NJ Practitioner - Family PracticePractitioner - Emergency Medicine 0446558324 Reassigns benefits to 2 organizations
I20241016004945 PA Practitioner - Family Practice 0446558324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

605 W State St
Internal Meds Media
Media, PA 19063-2620
Phone (610) 535-8600

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
DRX Paramus, LLC CurrentSince Oct 1, 2024 Accepting new patients
Prohealth Urgent Care Medicine of New Jersey LLP CurrentSince Aug 5, 2020 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine CurrentSince Oct 25, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Oct 25, 2024 Accepting new patients
The Radiology Group of New Jersey, LLC CurrentSince Jan 1, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Past Accepting new patients

Locations

1210 Route 130 N
Ste 1438
Cinnaminson, NJ 08077
Phone (551) 313-0170

2001 College Dr
Ste 11
Clementon, NJ 08021
Phone (856) 566-3333

3130 State Route 10
Denville, NJ 07834
Phone (973) 319-4230

415 W Saint Georges Ave
Linden, NJ 07036
Phone (908) 925-0363

1120 US Highway 9
Old Bridge, NJ 08857
Phone (732) 200-7800

67 E Ridgewood Ave
Unit C
Paramus, NJ 07652
Phone (201) 262-2010

1 Harmon Plz
Ste 1010
Secaucus, NJ 07094

605 W State St
Media, PA 19063
Phone (610) 565-8600

605 W State St
#2
Media, PA 19063
Phone (610) 565-8600

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1164806048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 WEST STATE STREET",
            "address_2": "2ND FLOOR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632620",
            "telephone_number": "301-752-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 WEST STATE STREET",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632620",
            "telephone_number": "301-752-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICK",
        "first_name": "PRESTON",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-10",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS022514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.