Michael Kamens, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

05015361 Issued in PA

Practice address

308 Student Health Center
University Park, PA 16802

Phone

(814) 863-6747

Fax

(814) 863-8464

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1215934385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 STUDENT HEALTH CENTER",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "16802",
            "telephone_number": "814-863-6747",
            "fax_number": "814-863-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 STUDENT HEALTH CENTER",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "16802",
            "telephone_number": "814-863-6747",
            "fax_number": "814-863-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMENS",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "05015361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0260499",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000375",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00061294",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey S Jackson
• Allison Jacobs
• Hope Jasper, RN
• Tesa Johns, ATC, LAT
• Michelle Johnson, LPN
• Barbie Kane
• Kristen M Kelly, CRNP
• Jenna Marie Kephart, RN
• Lynn Parker Klees, R.D.
• Constance Kossan, MA CCC SLP

• Family Medicine Physician in University Park, PA
• Providers in University Park, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.