Earl Kidwell Jr., MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD13643 Issued in DC

Practice address

3104 Lord Baltimore Dr
Suite 200
Baltimore, MD 21244-2898

Phone

(410) 265-1501

Fax

(410) 265-1504

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Ophthalmology

Education

Johns Hopkins University School of Medicine, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Howard UniversityGroup PAC ID 0941109565, 182 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Howard University Hospital Corp Hospital, Washington, DC, CCN 090003

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Howard University

  • Multi-Specialty Clinic/Center
  • Washington, DC
  • NPI 1033163597
  Medicare reassignment Care Compare group NPD
• Global Vision Center

  • Eyewear Supplier
  • Parkville, MD
  • NPI 1194763128

  Multi-Specialty

  NPD (past)
• Howard University

  • Multi-Specialty Clinic/Center
  • Washington, DC
  • NPI 1215582978
  NPD (past)

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

• Howard University Hospital Corp

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1487740957
  Care Compare affiliation

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1689757254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 LORD BALTIMORE DR",
            "address_2": "SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212442898",
            "telephone_number": "410-265-1501",
            "fax_number": "410-265-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 LORD BALTIMORE DR",
            "address_2": "SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212442898",
            "telephone_number": "410-265-1501",
            "fax_number": "410-265-1504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 Georgia Ave NW Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200602898",
            "country_code": "US",
            "telephone_number": "202-865-1257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "EARL",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D18526",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "DC",
            "license": "MD13643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188961300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kidkinetics Therapy LLC
• Kidney Home Center, LLC
• Michael S Kidorf, PH.D.
• Kids First PT, LLC
• Corey Kidwell
• Monica Kiefer
• James David Kielek, PA-C
• James David Kielek Jr., PA-C
• Kim Luise Kiernan, M.S. CCC-SP
• Ana Ponce Kiess, M.D., PH.D.

• Ophthalmology Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Ophthalmology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.