Active NPI
Kerry M Fagelman, MD
- Pediatric Surgery Physician
- Camp Hill, PA
National Provider Identifier
1679539621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- MD031250E
- Practice address
- 101 Erford Rd
Suite 101
Camp Hill, PA 17011-1802 - Phone
- (800) 233-4082
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | MD031250E | PA | Primary |
Addresses
Primary practice location
101 Erford Rd
Suite 101
Camp Hill, PA 17011-1802
Mailing address
PO Box 854
MC A410
Hershey, PA 17033-0854
Phone (800) 233-4082
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009636720004 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Health Medical Services | Past | Accepting new patients |
Organizations & group practices 1
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.
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- NPI 1295552073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255305600000",
"number": "1679539621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 854",
"address_2": "MC A410",
"city": "HERSHEY",
"state": "PA",
"postal_code": "170330854",
"telephone_number": "800-233-4082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 ERFORD RD",
"address_2": "SUITE 101",
"city": "CAMP HILL",
"state": "PA",
"postal_code": "170111802",
"telephone_number": "800-233-4082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGELMAN",
"first_name": "KERRY",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2009-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "PA",
"license": "MD031250E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009636720004",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Camp Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.