Dylan Gary Kilmer

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP022372 Issued in PA

Practice address

127 Route 106
Greenfield Township, PA 18407-3526

Phone

(570) 282-5189

NPI assigned

Jun 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkilmer@nepachc.medentdirect.com

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.

• B-K Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Hallstead, PA
  • NPI 1245272707
  NPD
• B-K Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Montrose, PA
  • NPI 1619352978
  NPD
• B-K Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Greenfield Township, PA
  • NPI 1952801037
  NPD (past)

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1679198220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 VESTAL PKWY E",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139024400",
            "telephone_number": "607-777-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 ROUTE 106",
            "city": "GREENFIELD TOWNSHIP",
            "state": "PA",
            "postal_code": "184073526",
            "telephone_number": "570-282-5189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "498 S Main St Ste D",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "PA",
            "postal_code": "188011317",
            "country_code": "US",
            "telephone_number": "570-278-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4400 Vestal Pkwy E",
            "address_purpose": "LOCATION",
            "city": "Binghamton",
            "state": "NY",
            "postal_code": "139024400",
            "country_code": "US",
            "telephone_number": "607-777-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILMER",
        "first_name": "DYLAN",
        "middle_name": "GARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP022372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B-K Health Center, Inc.
• Shelley Garrick
• Kayla Gatto, CRNP
• Greenfield TWP. Vol. Fire Co.
• Jennifer Lee Malak, P.T.
• Kimberly Mazzoni, RDLDN
• Melissa McPartland, D.C.
• Alanna O'Malley
• Mary Retzbach

• Psychiatric/Mental Health Nurse Practitioner in Greenfield Township, PA
• Providers in Greenfield Township, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.