NPIMap

Individual provider Active NPI

Kevin Dabundo, D.O.

  • Family Medicine Physician
  • West Chester, PA
National Provider Identifier
1811258866
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0S017436 Issued in PA
Practice address
1161 McDermott Dr Ste 101
West Chester, PA 19380-4064
Phone
(610) 701-7011
Fax
(610) 429-5199
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT014517 PA
Family Medicine Physician 207Q00000X 0S017436 PA Primary

Addresses

Primary practice location

1161 McDermott Dr Ste 101
West Chester, PA 19380-4064

Mailing address

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 337-1667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150617002670 PA Practitioner - Family Practice 8224349253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1161 McDermott Dr
Suite 101
West Chester, PA 19380-4042
Phone (610) 701-7011

Hospital & facility affiliations

  • Main Line Health Home Care & Hospice - Home Health Home health agency, Radnor, PA, CCN 397012
  • Penn Medicine Home Health Home health agency, Bala Cynwyd, PA, CCN 397125
  • Bayada Home Health Care, Inc. Home health agency, Exton, PA, CCN 398263
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Bryn Mawr Rehabilitation Hospital Inpatient rehabilitation facility, Malvern, PA, CCN 393025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0S017436PAMDFamily Medicine Physician
OT014517PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Jun 27, 2022 Accepting new patients
Prospect Health Access Network, Inc. Family Medicine CurrentSince Jul 1, 2016 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

1161 McDermott Dr
Ste 101
West Chester, PA 19380
Phone (610) 701-7011

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1811258866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1667",
            "fax_number": "484-337-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 MCDERMOTT DR STE 101",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804064",
            "telephone_number": "610-701-7011",
            "fax_number": "610-429-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABUNDO",
        "first_name": "KEVIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT014517",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "0S017436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.