Individual provider Active NPI

David A Elkins, M.D., PH.D.

  • Urology Physician
  • Salem, OR
National Provider Identifier
1821159187
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD2021-0337 Issued in NM
Practice address
2973 12TH Street SE
Salem, OR 97302-6162
Phone
(503) 561-7100
Fax
(503) 561-7124
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD24434 OR
Urology Physician 208800000X MD2021-0337 NM Primary
Urology Physician 208800000X 29019 AZ

Addresses

Primary practice location

2973 12TH Street SE
Salem, OR 97302-6162

Mailing address

1712 Sycamore Ave
Kingman, AZ 86409-0927
Phone (928) 681-8686

Other identifiers 1

IdentifierTypeStateIssuer
227295MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210623001039 AZ Practitioner - Urology 0648464818 Reassigns benefits to 1 organization
I20210721001206 NM Practitioner - Urology 0648464818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Loma Linda University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kingman Healthcare IncGroup PAC ID 6901791367, 185 clinicians

Practice addresses (Care Compare)

1712 Sycamore Ave
Kingman, AZ 86409-0927
Phone (928) 681-8686

Hospital & facility affiliations

  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Merit-based Incentive Payment System (MIPS)

Final score
84.85 of 100Reported as group
Quality
84.49
Promoting interoperability
83
Improvement activities
40
Cost
79.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2021-0337NMMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kingman Healthcare, Inc CurrentSince Jun 1, 2021 Accepting new patients
Presbyterian Healthcare Services Family Medicine CurrentSince Jul 26, 2021 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jul 26, 2021 Accepting new patients
Kingman Healthcare, Inc Family Medicine CurrentSince Jun 1, 2021 Accepting new patients
Kingman Healthcare, Inc Family Medicine Current Accepting new patients

Locations

1712 Sycamore Ave
Kingman, AZ 86409
Phone (928) 681-8570

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

201 Cedar St SE
Ste 5660
Albuquerque, NM 87106
Phone (505) 563-6565

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: elkins.david@direct.azkrmc.md

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 1

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1821159187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 SYCAMORE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090927",
            "telephone_number": "928-681-8686",
            "fax_number": "928-681-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2973 12TH STREET SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026162",
            "telephone_number": "503-561-7100",
            "fax_number": "503-561-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKINS",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD24434",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NM",
            "license": "MD2021-0337",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "29019",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227295",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.