Kevin M DO, DO, MS

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

AA12345 Issued in PA

Practice address

500 University Dr
Hershey, PA 17033-2360

Phone

(717) 531-6597

Fax

(717) 531-7790

NPI assigned

Mar 25, 2024

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Science

State licenses

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1609626662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10519 RESEDA BLVD",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913263128",
            "telephone_number": "818-621-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-6597",
            "fax_number": "717-531-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "AA12345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Diskerud, LCSW
• Thomas Charles Dispenza, M.D.
• Donald James Dissinger, CRNP
• Laura Marie Divirgilio, MD
• Olivia Marie Dixon, ATC
• Vu DO, M.D.
• Alice Dobi
• Jodi L Dobslaw, CRNP
• Jennifer L Dobson, MD
• Leonard F Dobson, PA-C

• All providers in Hershey, PA
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.