NPIMap

Individual provider Active NPI

Dominick A Kistler, M.D.

  • Family Medicine Physician
  • Huntingdon, PA
National Provider Identifier
1417009820
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD044653L Issued in PA
Practice address
1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone
(814) 643-2290
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD044653L PA Primary

Addresses

Primary practice location

1225 Warm Springs Ave
Huntingdon, PA 16652-2350

Mailing address

1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone (814) 643-2290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20110919000039 MA Practitioner - Family Practice 9032112123 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Physicians of Harvard Medical Faculty Physicians at Beth IsGroup PAC ID 6305749987, shared by 7 NPIs, 566 clinicians

Practice addresses (Care Compare)

199 Reedsdale Rd
Milton, MA 02186-3926
Phone (617) 696-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD044653LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Sep 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jan 1, 2015 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jan 1, 2015 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jan 1, 2015 Accepting new patients
Broad Top Area Medical Center, Inc Past Accepting new patients
Beth Israel Deaconess Hospital Plymouth, Inc. Family Medicine Past Accepting new patients
Jordan Physician Associates, Inc. Family Medicine Past Accepting new patients
Jordan Physician Associates, Inc. Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Organizations & group practices 9

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 2

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417009820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 WARM SPRINGS AVE",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166522350",
            "telephone_number": "814-643-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WARM SPRINGS AVE",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166522350",
            "telephone_number": "814-643-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTLER",
        "first_name": "DOMINICK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD044653L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, PA

Sources for this page

Verify at the official NPI Registry.