Mark David Kidwell, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101022590 Issued in MI

Practice address

3955 Patient Care Dr Ste a
Lansing, MI 48911

Phone

(517) 374-7600

Fax

(885) 480-9150

NPI assigned

Jun 13, 2016

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Family Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Capital Internal Medicine Associates P.C.Group PAC ID 8022097963, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
• McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkidwell357946@direct.hfhs.org
• Direct secure messaging: mark.kidwell@cimamed.eclinicaldirectplus.com

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.

• Capital Internal Medicine Associates P.C.

  • Internal Medicine Physician
  • Lansing, MI
  • NPI 1780629832

  Family Medicine

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  Care Compare affiliation
• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719
  Care Compare affiliation
• McLaren Greater Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1134104672
  Care Compare affiliation

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1366892150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 PATIENT CARE DR STE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114271",
            "telephone_number": "517-374-7600",
            "fax_number": "885-480-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 PATIENT CARE DR STE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48911",
            "telephone_number": "517-374-7600",
            "fax_number": "885-480-9150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 E Michigan Ave",
            "address_2": "Suite 245",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121800",
            "country_code": "US",
            "telephone_number": "517-364-5252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 E Michigan Ave",
            "address_2": "Suite 245",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121800",
            "country_code": "US",
            "telephone_number": "517-364-5252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Mustansir Mehdi Khan
• Saniya Khan, M.D
• Rohin Khanna, M.D
• Shaun Khoo, M.D.
• Farwa Khurshid, MD
• David Kiebler
• Britney Marie Kieft
• Lloyd Richard Kieft Jr., ATC
• Laura Elizabeth Kien
• Scott Kiesel, RSW

• Family Medicine Physician in Lansing, MI
• Providers in Lansing, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.