Charles Edward Kollmer, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

ME0065222 Issued in FL

Practice address

812 W Indian River Blvd
Edgewater, FL 32132-3429

Phone

(386) 426-1411

Fax

(386) 426-0457

NPI assigned

Aug 17, 2006

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 FL

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

Specialty

Orthopedic Surgery

Education

Medical College of Pennsylvania, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Smyrna Orthopedics PAGroup PAC ID 2365417391, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Concierge Home Care Home health agency, Port Orange, FL, CCN 687137
• Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
• Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• New Smyrna Orthopedics PA

  • Orthopaedic Surgery Physician
  • Edgewater, FL
  • NPI 1760596902
  Medicare reassignment Care Compare group NPD Authorized official

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

• Altercare LLC

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1871529347
  Care Compare affiliation
• Concierge Home Care of Port Orange LLC

  • Home Health Agency
  • Port Orange, FL
  • NPI 1801494505
  Care Compare affiliation
• Memorial Health Systems Inc

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• Southeast Volusia Healthcare Corporation

  • General Acute Care Hospital
  • New Smyrna Beach, FL
  • NPI 1871977942
  Care Compare affiliation

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1821102047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 W INDIAN RIVER BLVD",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321323429",
            "telephone_number": "386-426-1411",
            "fax_number": "386-426-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 W INDIAN RIVER BLVD",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321323429",
            "telephone_number": "386-426-1411",
            "fax_number": "386-426-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLMER",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0065222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002875400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iq Academy. Inc
• Michael Eugene Johnson, M.D.
• K Ville LLC
• Amy Jo Kelly
• Tina Kendrick
• Kelly Koons, RD, CDE, LD
• Orest Michael Krajnyk, MD
• L S Superior Billing,LLC
• Amanda Sharon Lange, L.M.T.
• Kathy Lanthorne, BS MS LMHC

• Orthopaedic Surgery Physician in Edgewater, FL
• Providers in Edgewater, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.