Active NPI
Roy R. Kinder Jr., MD
- Dermatology Physician
- Upper Darby, PA
National Provider Identifier
1376571067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD032726L
- Practice address
- 35 Brandon Rd
Upper Darby, PA 19082-2504 - Phone
- (610) 352-9021
- Fax
- (610) 352-4015
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD032726L | PA | Primary |
Addresses
Primary practice location
35 Brandon Rd
Upper Darby, PA 19082-2504
Mailing address
35 Brandon Rd
Upper Darby, PA 19082-2504
Phone (610) 352-9021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016071250001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD032726L | PA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367280000000",
"number": "1376571067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 BRANDON RD",
"city": "UPPER DARBY",
"state": "PA",
"postal_code": "190822504",
"telephone_number": "610-352-9021",
"fax_number": "610-352-4015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 BRANDON RD",
"city": "UPPER DARBY",
"state": "PA",
"postal_code": "190822504",
"telephone_number": "610-352-9021",
"fax_number": "610-352-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINDER",
"first_name": "ROY",
"middle_name": "R.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2013-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "PA",
"license": "MD032726L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016071250001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Upper Darby, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.