NPIMap

Individual provider Active NPI

Kailas D Dave, MD FAAP

  • Pediatrics Physician
  • Hazleton, PA
National Provider Identifier
1811976327
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD044209L Issued in PA
Practice address
316 Goshen Avenue
Hazleton, PA 18201-0603
Phone
(570) 436-1635
Fax
(570) 434-1635
NPI assigned
Jan 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD044209L PA Primary

Addresses

Primary practice location

316 Goshen Avenue
Hazleton, PA 18201-0603

Mailing address

PO Box 603
Hazleton, PA 18201-0603
Phone (570) 436-1635

Other identifiers 3

IdentifierTypeStateIssuer
0012719660004MedicaidPA
138534OtherMED PLUS UNISON
001393OtherFIRST PRIORITY HEALTH

Other names 1

  • Kailas R. Dave Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Area Healthcare PC Past Accepting new patients
Coastal Inpatient Physicians, LLC Past Accepting new patients
Ea Health Physicians Medical Group - National LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1811976327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182010603",
            "telephone_number": "570-436-1635",
            "fax_number": "570-436-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 GOSHEN AVENUE",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182010603",
            "telephone_number": "570-436-1635",
            "fax_number": "570-434-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "KAILAS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD FAAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD044209L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012719660004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED PLUS UNISON",
            "identifier": "138534",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "001393",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILAS",
            "last_name": "DAVE",
            "middle_name": "R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hazleton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.