Individual provider Active NPI

Richard L Kendall, MD

  • Emergency Medicine Physician
  • Port Clinton, OH
National Provider Identifier
1285648097
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35062349 Issued in OH
Practice address
135 W Perry St
Port Clinton, OH 43452-1010
Phone
(419) 732-7800
Fax
(419) 797-4843
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35062349 OH Primary
General Practice Physician 208D00000X 35062349 OH

Addresses

Primary practice location

135 W Perry St
Port Clinton, OH 43452-1010

Mailing address

135 W Perry St
Port Clinton, OH 43452-1010
Phone (419) 732-7800

Other identifiers 3

IdentifierTypeStateIssuer
0872515MedicaidOH
4194361OtherOHMEDICARE PTAN
P00342604OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20061108000642 OH Practitioner - Emergency MedicinePractitioner - General Practice 5294732046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: General Practice
Education
Ohio State University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

135 W Perry St
Port Clinton, OH 43452-1010
Phone (419) 732-7800

Hospital & facility affiliations

  • Magruder Hospital Hospital, Port Clinton, OH, CCN 361314

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35062349OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Primary Care Corporation CurrentSince May 15, 2008 Accepting new patients
Tiffin Emergency Services, LLC Emergency Medicine Past Accepting new patients

Locations

135 W Perry St
Port Clinton, OH 43452
Phone (419) 693-3344

Organizations & group practices 2

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 1

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381708800000",
    "number": "1285648097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W PERRY ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521010",
            "telephone_number": "419-732-7800",
            "fax_number": "419-797-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W PERRY ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521010",
            "telephone_number": "419-732-7800",
            "fax_number": "419-797-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "RICHARD",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35062349",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35062349",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0872515",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4194361",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00342604",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Clinton, OH

Sources for this page

Verify at the official NPI Registry.