NPIMap

Individual provider Active NPI

Kevin Michael Walsh, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Bryn Mawr, PA
National Provider Identifier
1245291657
Registry record updated Jan 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
MD074337 Issued in PA
Practice address
931 E Haverford Rd
Suite 200
Bryn Mawr, PA 19010-3838
Phone
(610) 520-6170
Fax
(610) 520-6174
NPI assigned
Mar 28, 2006
Last updated
Jan 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MD074337 PA Primary

Addresses

Primary practice location

931 E Haverford Rd
Suite 200
Bryn Mawr, PA 19010-3838

Mailing address

931 E Haverford Rd
Suite 200
Bryn Mawr, PA 19010-3838
Phone (610) 520-6170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101115001190 PA Practitioner - Family Practice 7113112210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1396 Wilmington Pike
West Chester, PA 19382-8218
Phone (610) 399-1138

2004 Sproul Rd
FL 1
Broomall, PA 19008-3511
Phone (610) 353-0800

470 John Young Way
Suite 100
Exton, PA 19341-2557
Phone (610) 363-6589

525 W Chester Pike
Suite 101a
Havertown, PA 19083-4539
Phone (610) 449-2000

656 E Swedesford Rd
Suite 101
Wayne, PA 19087-1622
Phone (484) 768-9106

931 E Haverford Rd
Bryn Mawr, PA 19010-3838

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD074337PAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Associates, LTD Sports Medicine CurrentSince Aug 1, 2012 Accepting new patients
Valor Sports Medicine and Wellness Sports Medicine Current Accepting new patients
Premier Orthopaedic and Sports Medicine Associates LTD CurrentSince Aug 1, 2012 Accepting new patients
Orthopaedic Specialists, P.C. Current Accepting new patients

Locations

2004 Sproul Rd
Fl 1
Broomall, PA 19008
Phone (610) 353-0800

27 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (610) 527-1762

931 E Haverford Rd
Ste 200
Bryn Mawr, PA 19010
Phone (610) 520-6170

Interoperability endpoints

  • Direct secure messaging: kevin.walsh.1@22724.direct.athenahealth.com
  • Direct secure messaging: kevinwalsh@po.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359158400000",
    "number": "1245291657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 E HAVERFORD RD",
            "address_2": "SUITE 200",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103838",
            "telephone_number": "610-520-6170",
            "fax_number": "610-520-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 E HAVERFORD RD",
            "address_2": "SUITE 200",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103838",
            "telephone_number": "610-520-6170",
            "fax_number": "610-520-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2013-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD074337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.