Kevin Kalwerisky, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

35095386 Issued in OH

Practice address

101 Bodin Cir
60 MDG / Sgcxe
Travis Afb, CA 94535-1809

Phone

(707) 423-3531

Fax

(707) 423-3260

NPI assigned

Apr 10, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in MO

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

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.

• Lawrence E. Samuels M.D., Inc.

  • Dermatology Physician
  • Chesterfield, MO
  • NPI 1225179724
  Medicare reassignment NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Mercy Clinic Dermatology LLC

  • Dermatology Physician
  • Washington, MO
  • NPI 1033470745
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1801019898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "60 MDG / SGCXE",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3531",
            "fax_number": "707-423-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "60 MDG / SGCXE",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3531",
            "fax_number": "707-423-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALWERISKY",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35095386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "35095386",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Harris Jones, MD
• Nicholas Alexander Jones, O.D.
• Kristin Joy
• Robert Hideo Judy, DDS
• Jenny Y Jung
• Sophia Kyein Kang
• Sumandeep Kaur, PSY.D.
• Ben Kavoussi, MS, PA-C
• Prajeet Kaza, MD
• Monika KC, DO

• Ophthalmology Physician in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.