Panyamol Pam Kittipongdaja, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS018946 Issued in PA

Practice address

500 Evergreen Dr Ste 20
Glen Mills, PA 19342-1032

Phone

(484) 785-3376

NPI assigned

Nov 4, 2013

Last updated

Aug 8, 2026By the provider in NPPES

Sex

Female

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 PA

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

Dermatology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associates in Medical and Cosmetic Dermatology, PCGroup PAC ID 4385624931, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.19 of 100Reported as group

Quality

93.33

Promoting interoperability

100

Improvement activities

40

Cost

77.31

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pamkitti@brintonlakedermatology.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associates in Medical and Cosmetic Dermatology, PC

  • Specialist
  • Glen Mills, PA
  • NPI 1477639425
  Medicare reassignment Care Compare group NPD
• Andrew K Pollack, MD

  • Dermatology Physician
  • Fort Washington, PA
  • NPI 1063416006
  Medicare reassignment
• Andrew K Pollack

  • Dermatology Physician
  • Fort Washington, PA
  • NPI 1760555924
  NPD (past)

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1861821589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 EVERGREEN DR STE 20",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421032",
            "telephone_number": "484-785-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EVERGREEN DR STE 20",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421032",
            "telephone_number": "484-785-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTIPONGDAJA",
        "first_name": "PANYAMOL",
        "middle_name": "PAM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OS018946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103374660-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosemary Kerwin, PHARMD
• Mitchell Robert Chiong Kho, MD
• Heather Kiesel
• Bernard F. King, D.O.
• Jenna Kirk, DPT
• KJ Healthcare Group LLC
• Julia N Kleckner, PHARMD
• Barbara Cheyney Knickerbocker, PHD
• Angela Koehler
• Alia Koertner

• Dermatology Physician in Glen Mills, PA
• Providers in Glen Mills, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; 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.