Robert W Kaville, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD037576E Issued in PA

Practice address

101 Berry Hill Rd
Roaring Brook TWP, PA 18444-7611

Phone

(570) 348-2280

Fax

(570) 348-0647

NPI assigned

Mar 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

State licenses

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1770542789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BERRY HILL RD",
            "city": "ROARING BROOK TWP",
            "state": "PA",
            "postal_code": "184447611",
            "telephone_number": "570-348-2280",
            "fax_number": "570-348-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BERRY HILL RD",
            "city": "ROARING BROOK TWP",
            "state": "PA",
            "postal_code": "184447611",
            "telephone_number": "570-348-2280",
            "fax_number": "570-348-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVILLE",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD037576E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1128600",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Roaring Brook TWP, PA
• Providers in Roaring Brook TWP, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.