NPIMap

Organization Active NPI

Kilgalen Associates PA

  • Clinical Social Worker
  • Fallston, MD
National Provider Identifier
1861598484
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
03374 Issued in MD
Legal business name
KILGALEN ASSOCIATES PA
Practice address
1716 Harford Rd
Suite 204
Fallston, MD 21047
Phone
(410) 877-7207
Fax
(410) 877-7224
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James F Kilgalen, LCSW CNPI 1447466172
Title
Director Sr Clinician
Phone
(410) 877-7207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 03374 MD Primary

Addresses

Primary practice location

1716 Harford Rd
Suite 204
Fallston, MD 21047

Mailing address

1716 Harford Rd
Suite 204
Fallston, MD 21047
Phone (410) 877-7207

Other identifiers 2

IdentifierTypeStateIssuer
KC83OtherMDBLUE CROSS BLUE SHIELD
T460OtherMDBLUE CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050407000799 MD Part B Supplier - Clinic/Group Practice 1557318854 Receives reassigned benefits from 6 practitioners
Practice locations: Fallston, MD

National Provider Directory

National Provider Directory

Locations

1716 Harford Rd
Ste 204
Fallston, MD 21047
Phone (410) 877-7207

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861598484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 HARFORD RD",
            "address_2": "SUITE 204",
            "city": "FALLSTON",
            "state": "MD",
            "postal_code": "21047",
            "telephone_number": "410-877-7207",
            "fax_number": "410-877-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 HARFORD RD",
            "address_2": "SUITE 204",
            "city": "FALLSTON",
            "state": "MD",
            "postal_code": "21047",
            "telephone_number": "410-877-7207",
            "fax_number": "410-877-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILGALEN ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KILGALEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR SR CLINICIAN",
        "authorized_official_telephone_number": "410-877-7207",
        "authorized_official_credential": "LCSW C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "03374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "KC83",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "T460",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallston, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.