Individual provider Active NPI

Douglas Arlyn Kinkel, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Las Cruces, NM
National Provider Identifier
1417003377
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
90-224 Issued in NM
Practice address
2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Phone
(706) 354-5770
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 90-224 NM Primary

Addresses

Primary practice location

2450 S Telshor Blvd
Las Cruces, NM 88011-5069

Mailing address

PO Box 5719
Athens, GA 30604-5719
Phone (706) 354-5770

Other identifiers 1

IdentifierTypeStateIssuer
25445MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20041124000645 NM Practitioner - Emergency Medicine 3173588563 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
90-224NMMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Staffing Solutions Inc CurrentSince Jul 12, 2015 Accepting new patients
Ess Hospitalist LLC CurrentSince Jul 12, 2015 Accepting new patients
Fedko Emergency Physicians New Mexico LLC CurrentSince Aug 1, 2023 Accepting new patients
First Step Center Past Accepting new patients

Locations

900 W Ash St
Deming, NM 88030
Phone (505) 546-2761

1016 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-4446

1313 E 32nd St
Silver City, NM 88061
Phone (505) 537-4953

800 E 9th Ave
Truth Or Consequences, NM 87901
Phone (505) 743-1270

Interoperability endpoints

  • Direct secure messaging: dakinkel@yourcarecommunity.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1417003377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5719",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306045719",
            "telephone_number": "706-354-5770",
            "fax_number": "706-354-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115069",
            "telephone_number": "706-354-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINKEL",
        "first_name": "DOUGLAS",
        "middle_name": "ARLYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NM",
            "license": "90-224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25445",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.