Stephen G. Kimmel, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

ME90982 Issued in FL

Practice address

450 W Medical Center Blvd
Suite 600C
Webster, TX 77598-4234

Phone

(281) 554-1690

Fax

(281) 316-0590

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Magella Medical Associates Billing, Inc.

  • Neonatal-Perinatal Medicine Physician
  • Round Rock, TX
  • NPI 1083631071
  Medicare reassignment NPD
• Houston Pediatric Specialty Group PLLC

  • Pediatric Pulmonology Physician
  • Houston, TX
  • NPI 1609047687
  Medicare reassignment

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1700892148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NEMOURS CHILDREN&APOS S CLINIC",
            "address_2": "P.O. BOX 409992",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840001",
            "telephone_number": "904-390-3610",
            "fax_number": "904-288-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W MEDICAL CENTER BLVD",
            "address_2": "SUITE 600C",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984234",
            "telephone_number": "281-554-1690",
            "fax_number": "281-316-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "STEPHEN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "FL",
            "license": "ME90982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270540100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009964275",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09680055",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "STEPHEN.KIMMEL@hca9.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "450 W Medical Center Blvd",
            "address_2": "SUITE 600C",
            "city": "Webster",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775984234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Russell Kilgore, OTR
• Chung Y Kim, M.D.
• Daniel Y Kim, M.D.
• Tyler Kim
• Avolonne Morgan Kimble, MD
• Kiran Rajneesh PLLC
• Eda Kivrak
• Irene Kizito
• Geffrey H Klein, M.D.
• Steven Kloeris, MD

• Pediatric Surgery Physician in Webster, TX
• Providers in Webster, TX by specialty
• Pediatric Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.