NPIMap

Individual provider Active NPI

Kinshasa D Kilgore, PA

  • Physician Assistant
  • Crofton, MD
National Provider Identifier
1740432814
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C05240 Issued in MD
Practice address
2131 Davidsonville Rd
Crofton, MD 21114-1632
Phone
(410) 721-1000
NPI assigned
Oct 21, 2008
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA06008 TX
Physician Assistant 363A00000X C05240 MD Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

2131 Davidsonville Rd
Crofton, MD 21114-1632

Mailing address

4601 Martin Luther King Jr Ave SW
Washington, DC 20032-1131
Phone (571) 249-3487

Other practice location 1

4601 Martin Luther King Jr Ave SW
Washington, DC 20032-1131
Phone (571) 249-3487

Other identifiers 2

IdentifierTypeStateIssuer
198312401MedicaidTX
8Y8981OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121026000455 DC Practitioner - Physician Assistant 9638231624 Reassigns benefits to 7 organizations
I20160616002043 MD Practitioner - Physician Assistant 9638231624 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chase Brexton Health Services IncGroup PAC ID 5395644835, 119 clinicians

Practice addresses (Care Compare)

1111 N Charles St
Baltimore, MD 21201-5505
Phone (410) 837-2050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C05240MDMDPhysician Assistant
PA06008TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 1, 2019 Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Nov 3, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 1, 2019 Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Nov 3, 2025 Accepting new patients
University of Maryland Oncology Associates, PA CurrentSince Apr 13, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. Past Accepting new patients
Whipple Tree Emergency Physicians LLC Physician Assistant Past Accepting new patients

Locations

1111 N Charles St
Baltimore, MD 21201
Phone (410) 486-5991

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500

655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100

2101 E Jefferson St
#4E
Rockville, MD 20852

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1740432814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 MARTIN LUTHER KING JR AVE SW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200321131",
            "telephone_number": "571-249-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 DAVIDSONVILLE RD",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141632",
            "telephone_number": "410-721-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4601 Martin Luther King Jr Ave SW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200321131",
            "country_code": "US",
            "telephone_number": "571-249-3487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILGORE",
        "first_name": "KINSHASA",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06008",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C05240",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198312401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8Y8981",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

Verify at the official NPI Registry.