Individual provider Active NPI

Kevin M Kitagawa, MD

  • Specialist
  • Bangor, ME
National Provider Identifier
1538363171
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD19249 Issued in ME
Practice address
417 State St
Suite 439
Bangor, ME 04401-6635
Phone
(207) 941-8200
Fax
(207) 990-4848
NPI assigned
Jun 14, 2007
Last updated
Aug 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD19249 ME Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4754 HI

Addresses

Primary practice location

417 State St
Suite 439
Bangor, ME 04401-6635

Mailing address

417 State St
Suite 439
Bangor, ME 04401-6635
Phone (207) 941-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.83 of 100Reported as group
Quality
82.8
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19249MEMDSpecialist
4754HIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Pathologists' Laboratory Anatomic Pathology & Clinical Pathology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1538363171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "SUITE 439",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016635",
            "telephone_number": "207-941-8200",
            "fax_number": "207-990-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "SUITE 439",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016635",
            "telephone_number": "207-941-8200",
            "fax_number": "207-990-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITAGAWA",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ME",
            "license": "MD19249",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "HI",
            "license": "4754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.