Individual provider Active NPI

Kevin J. Kollman, M.D.

  • Internal Medicine Physician
  • Huntingdon, PA
National Provider Identifier
1578523833
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD040029L Issued in PA
Practice address
1100 Pike St
Huntingdon, PA 16654-0002
Phone
(814) 643-2400
Fax
(814) 643-9386
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD040029L PA Primary

Addresses

Primary practice location

1100 Pike St
Huntingdon, PA 16654-0002

Mailing address

1100 Pike St
Huntingdon, PA 16654-0002
Phone (814) 643-2400

Other identifiers 1

IdentifierTypeStateIssuer
001288945MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040721001060 PA Practitioner - Internal Medicine 4587644521 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2001 Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2001 Accepting new patients

Locations

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

100 N Academy Ave
Danville, PA 17822

210 Medical Center Dr
Philipsburg, PA 16866
Phone (814) 342-8001

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1578523833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PIKE ST",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166540002",
            "telephone_number": "814-643-2400",
            "fax_number": "814-643-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PIKE ST",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166540002",
            "telephone_number": "814-643-2400",
            "fax_number": "814-643-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLMAN",
        "first_name": "KEVIN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD040029L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001288945",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, PA

Sources for this page

Verify at the official NPI Registry.