Individual provider Active NPI

Keith Paul Kittelberger, MD

  • Anesthesiology Physician
  • Raleigh, NC
National Provider Identifier
1669583415
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
9300189 Issued in NC
Practice address
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone
(919) 784-3034
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 9300189 NC Primary
Interventional Pain Medicine Physician 208VP0014X 9300189 NC
Pain Medicine (Anesthesiology) Physician 207LP2900X 9300189 NC

Addresses

Primary practice location

4420 Lake Boone TRL
Raleigh, NC 27607-7505

Mailing address

PO Box 18139
Raleigh, NC 27619-8139

Other identifiers 5

IdentifierTypeStateIssuer
57299OtherNCMEDCOST
132EVOtherNCBCBS NC
25212OtherNCPARTNERS
6736408OtherNCCIGNA
89132EVMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040928000559 NC Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 3173592078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Meharry Medical College School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 784-3034

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC Anesthesiology Current Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Aug 1, 1993 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Aug 1, 1993 Accepting new patients
Perioperative Medicine Consultants, LLC Anesthesiology Past Accepting new patients
Anesthesia Resources of the Carolinas, P.a. Anesthesiology Past Accepting new patients

Locations

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

23 Sunnybrook Rd
Ste 100
Raleigh, NC 27610
Phone (919) 322-4800

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

2800 Blue Ridge Rd
Ste 301
Raleigh, NC 27607
Phone (919) 781-1420

2800 Blue Ridge Rd
Ste 204
Raleigh, NC 27607
Phone (919) 784-3200

Interoperability endpoints

  • Direct secure messaging: kkittelberger9173@direct.unc.nchie.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1669583415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18139",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276198139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTELBERGER",
        "first_name": "KEITH",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "9300189",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NC",
            "license": "9300189",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NC",
            "license": "9300189",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "57299",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "132EV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "25212",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6736408",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89132EV",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.