Individual provider Active NPI

David Kuo, DO

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1659373454
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS009642L Issued in PA
Practice address
4190 City Ave
Philadelphia, PA 19131-1626
Phone
(215) 871-6380
Fax
(215) 871-6381
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS009642L PA Primary

Addresses

Primary practice location

4190 City Ave
Philadelphia, PA 19131-1626

Mailing address

4190 City Ave
Philadelphia, PA 19131-1626
Phone (215) 871-6380

Other identifiers 2

IdentifierTypeStateIssuer
450298OtherPAMEDICARE PTAN
001736605MedicaidPA

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
I20040119000506 PA Practitioner - Family Practice 4789585019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Philadelphia College of Osteopathic MedicineGroup PAC ID 0648179234, 30 clinicians

Practice addresses (Care Compare)

4190 City Ave
Suite 315
Philadelphia, PA 19131-1633
Phone (215) 871-6384

4190 City Line Ave
Philadelphia, PA 19131-1626

4190 City Line Ave
Philadelphia, PA 19131-1633

Merit-based Incentive Payment System (MIPS)

Final score
79.67 of 100Reported as group
Quality
69.85
Promoting interoperability
54
Improvement activities
40
Cost
75.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS009642LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Medical Group LLC Family Medicine CurrentSince Oct 1, 2015 Accepting new patients
Philadelphia College of Osteopathic Medicine Past Accepting new patients

Locations

2701 DeKalb Pike
Fl 2
East Norriton, PA 19401
Phone (610) 275-1028

1437 DeKalb St
Ste 101
Norristown, PA 19401
Phone (610) 279-6621

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: david.kuo@direct.pcom.nextgenshare.com

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1659373454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-6380",
            "fax_number": "215-871-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-6380",
            "fax_number": "215-871-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUO",
        "first_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS009642L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "450298",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001736605",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.