Kurt Thomas Callison, D.O.
Individual provider Active NPI Family Medicine Physician · Painted Post, NY
NPI 1689014128 · NPPES record last updated Jun 9, 2016
Key facts
- NPI
- 1689014128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 279917 (NY)
- Practice address
- 418 S Hamilton St
Suite 109
Painted Post, NY 14870-9705 - Phone
- (607) 936-2089
- Fax
- (607) 936-8176
- NPI assigned
- Jun 28, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180116000763 | NY | Order and Referring Only - Family Practice |
8729391321 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arnot Ogden Medical Center | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 279917 | NY | Yes |
Addresses
Primary practice location
418 S Hamilton St
Suite 109
Painted Post, NY 14870-9705
Mailing address
571 Saint Josephs Blvd FL 2
Elmira, NY 14901-3230
Phone (607) 271-2050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103055103 | Medicaid | PA | |
| 04159835 | Medicaid | NY |
Other providers in Painted Post, NY
- Cheryl Jean Brewer
- Sherry Ann Brion
- Kristi Brown
- Mark Brzozowski
- Jessica Marie Burdick
- Carefirst Ny, Inc.
- Shannon Carey
- Kaylee Carr
- Michael Anthony Caruso
- Spencer Cavallaro
All providers in Painted Post, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.