Kevin B Decker, MD

Primary specialty

DentistTaxonomy code 122300000X

License

040681 Issued in NY

Practice address

32 Conkey Ave
Norwich, NY 13815-1762

Phone

(607) 337-4174

NPI assigned

Oct 23, 2006

Last updated

Dec 9, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1598848376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 STATE HWY #320",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "13815",
            "telephone_number": "607-336-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 CONKEY AVE",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138151762",
            "telephone_number": "607-337-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "KEVIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "040681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley J Czarnecki, MD
• Karen M Dague, LCSW-R
• Amber Marie Davis, RN
• David James Davis, L.C.S.W.-R
• Jill Christine Davis, LPN
• Delf O King MD PC
• Michael Anthony Dembik
• James Hamilton Dennis Jr.
• Linda Carol Denz
• Nicholas A Derensis, D.D.S.

• Dentist in Norwich, NY
• Providers in Norwich, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.