NPIMap

Individual provider Active NPI

Kevin D Tate, M.D.

  • Family Medicine Physician
  • Denton, MD
National Provider Identifier
1437169729
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0073949 Issued in MD
Practice address
609 Daffin LN
Denton, MD 21629-1392
Phone
(410) 479-2650
NPI assigned
Aug 9, 2006
Last updated
Jan 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101243883 VA
Family Medicine Physician 207Q00000X D0073949 MD Primary

Addresses

Primary practice location

609 Daffin LN
Denton, MD 21629-1392

Mailing address

920 Elkridge Landing Rd
Linthicum, MD 21090-2917
Phone (410) 684-2031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20120622000096 MD Practitioner - Family Practice 3779583802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

219 S Washington St
Easton, MD 21601-2913
Phone 41082210005845

2540 Centreville Rd
Centreville, MD 21617-2681
Phone (410) 822-1000

500 Cadmus LN
Easton, MD 21601-4094

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0073949MDMDFamily Medicine Physician
0101243883VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. Family Medicine CurrentSince Mar 20, 2016 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Mar 20, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

Interoperability endpoints

  • Direct secure messaging: ktate450840@direct.umm.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1437169729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 ELKRIDGE LANDING RD",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902917",
            "telephone_number": "410-684-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 DAFFIN LN",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291392",
            "telephone_number": "410-479-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "KEVIN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101243883",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0073949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, MD

Sources for this page

Verify at the official NPI Registry.