Individual provider Active NPI

Williiam B. Kilgore, M.D.

  • Orthopaedic Surgery Physician
  • Eureka, CA
National Provider Identifier
1508891029
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A94844 Issued in CA
Practice address
2826 Harris St
Eureka, CA 95503-4809
Phone
(707) 443-8066
Fax
(707) 268-3250
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A94844 CA Primary

Addresses

Primary practice location

2826 Harris St
Eureka, CA 95503-4809

Mailing address

2826 Harris St
Eureka, CA 95503-4809
Phone (707) 443-8066

Other identifiers 1

IdentifierTypeStateIssuer
00A948440MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wkilgore1657900@oc.providencedirect.org

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
I20060928000229 CA Practitioner - Orthopedic Surgery 6608871520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

200 W Ctr St Promenade
Anaheim, CA 92805-3960

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-8121

2710 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 267-2060

2826 Harris St
Eureka, CA 95503-4809
Phone (707) 443-8066

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

Hospital & facility affiliations

  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
  • Mad River Community Hospital Hospital, Arcata, CA, CCN 050028

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement60
Knee replacement57
Lower limb (leg) arthroscopy (minimally invasive joint repair)13
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Apr 1, 2011 Accepting new patients
Providence Medical Foundation CurrentSince Apr 1, 2011 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

2826 Harris St
Eureka, CA 95503
Phone (707) 443-8066

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Interoperability endpoints

  • Direct secure messaging: wkilgore1657900@oc.providencedirect.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.

Hospital & facility affiliations 4

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1508891029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2826 HARRIS ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034809",
            "telephone_number": "707-443-8066",
            "fax_number": "707-268-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2826 HARRIS ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034809",
            "telephone_number": "707-443-8066",
            "fax_number": "707-268-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILGORE",
        "first_name": "WILLIIAM",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A94844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A948440",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wkilgore1657900@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2826 Harris St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955034809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.