Individual provider Active NPI

Kirk Nicholas Campbell, M.D.

  • Nephrology Physician
  • New York, NY
National Provider Identifier
1184761389
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
231873 Issued in NY
Practice address
One Gustave L.Levy Place
New York, NY 10029-6574
Phone
(212) 987-7208
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME101992 FL
Nephrology Physician 207RN0300X 231873 NY Primary

Addresses

Primary practice location

One Gustave L.Levy Place
New York, NY 10029-6574

Mailing address

Box 3000
1 Gustave L.Levy Place
New York, NY 10029-6574
Phone (212) 987-3100

Other identifiers 1

IdentifierTypeStateIssuer
0002772-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070829000277 NY Practitioner - Nephrology 5698868180 Reassigns benefits to 1 organization
I20250602002807 PA Practitioner - Nephrology 5698868180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Connecticut School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St 210 White BLDG
Renal Electrolyte Hup
Philadelphia, PA 19104-4228
Phone (215) 662-2638

3400 Spruce St 210 White Building
Renal Electrolyte Hup
Philadelphia, PA 19104-4228
Phone (215) 662-2638

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Nephrology CurrentSince Aug 1, 2012 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2012 Accepting new patients
University of Penn - Medical Group Nephrology CurrentSince Mar 10, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 10, 2025 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

PO B0x 824320
Philadelphia, PA 19182

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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 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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1184761389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 3000",
            "address_2": "1 GUSTAVE L.LEVY PLACE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-987-3100",
            "fax_number": "212-731-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE GUSTAVE L.LEVY PLACE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-987-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KIRK",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME101992",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "231873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002772-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.