Individual provider Active NPI

Richard M Kelowitz, D.D.S.

  • General Practice Dentistry
  • Newberry, FL
National Provider Identifier
1184834384
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS020304L Issued in PA
Practice address
2165 NW 147TH St
Newberry, FL 32669-2043
Phone
(610) 417-4130
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS020304L PA Primary
Dentist 122300000X DN8554 FL

Addresses

Primary practice location

2165 NW 147TH St
Newberry, FL 32669-2043

Mailing address

Health Science Ctr
College of Dentistry
Gainesville, FL 32610-0412
Phone (610) 691-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160315001740 FL Order and Referring Only - DentistPractitioner - Dentist 1355647462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN8554FLMDDentist
DS020304LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1184834384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HEALTH SCIENCE CTR",
            "address_2": "COLLEGE OF DENTISTRY",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100412",
            "telephone_number": "610-691-6200",
            "fax_number": "610-691-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 NW 147TH ST",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326692043",
            "telephone_number": "610-417-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELOWITZ",
        "first_name": "RICHARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS020304L",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN8554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberry, FL

Sources for this page

Verify at the official NPI Registry.