Individual provider Active NPI

Robert Martin Kushmider, D.D.S.

  • General Practice Dentistry
  • Shoemakersville, PA
National Provider Identifier
1215083175
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-23554 Issued in PA
Practice address
1040 Shoemaker Ave
Shoemakersville, PA 19555-1639
Phone
(610) 565-2273
Fax
(610) 562-2273
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS-23554 PA Primary

Addresses

Primary practice location

1040 Shoemaker Ave
Shoemakersville, PA 19555-1639

Mailing address

1040 Shoemaker Ave
Shoemakersville, PA 19555-1639
Phone (610) 565-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150623000335 PA Order and Referring Only - DentistPractitioner - Dentist 1850602566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS-23554PAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215083175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SHOEMAKER AVE",
            "city": "SHOEMAKERSVILLE",
            "state": "PA",
            "postal_code": "195551639",
            "telephone_number": "610-565-2273",
            "fax_number": "610-562-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 SHOEMAKER AVE",
            "city": "SHOEMAKERSVILLE",
            "state": "PA",
            "postal_code": "195551639",
            "telephone_number": "610-565-2273",
            "fax_number": "610-562-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHMIDER",
        "first_name": "ROBERT",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-23554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoemakersville, PA

Sources for this page

Verify at the official NPI Registry.