Individual provider Active NPI

Douglas Wayne Kindall, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Sacramento, CA
National Provider Identifier
1457374076
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
G60717 Issued in CA
Practice address
129 Meister Way
Sacramento, CA 95819-1921
Phone
(916) 329-9210
Fax
(916) 329-9218
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X G60717 CA Primary

Addresses

Primary practice location

129 Meister Way
Sacramento, CA 95819-1921

Mailing address

PO Box 19133
Sacramento, CA 95819-0133
Phone (916) 329-9210

Other identifiers 1

IdentifierTypeStateIssuer
00G607170MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20061031000266 CA Practitioner - Physical Medicine and Rehabilitation 0840297081 Practice locations: Sacramento, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Arizona College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Sacramento, CA 95819
Phone (916) 329-9210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G60717CAMDPhysical Medicine & Rehabilitation Physician

Hospital & facility affiliations 3

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1457374076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19133",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958190133",
            "telephone_number": "916-329-9210",
            "fax_number": "916-329-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 MEISTER WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958191921",
            "telephone_number": "916-329-9210",
            "fax_number": "916-329-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDALL",
        "first_name": "DOUGLAS",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G60717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G607170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.