Kelly C Gordon Dubs, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

232457 Issued in NY

Practice address

250 Pettit Avenue
Suite 4
Bellmore, NY 11710

Phone

(516) 409-0106

Fax

(516) 409-0108

NPI assigned

May 23, 2007

Last updated

Mar 11, 2010By 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

Medicare fee-for-service enrollment

Enrolled in NY

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

Nephrology

Education

State University of New York at Buffalo School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prine Health Medical Group, PLLCGroup PAC ID 1557600384, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Freeport Kidney Center Dialysis facility, Freeport, NY, CCN 332529
• Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259
• Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198
• Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: kgordondubs@prine.curemd.direct-ci.com

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.

• Prine Health Medical Group, PLLC

  dba PRINE Podiatry

  • Nephrology Physician
  • Manhasset, NY
  • NPI 1144790163
  Medicare reassignment Care Compare group NPD
• Prine Health Medical Group, PLLC

  dba PRINE Podiatry

  • Podiatrist
  • Hicksville, NY
  • NPI 1538868336
  NPD
• Prine Health Medical Group, PLLC

  dba PRINE Podiatry

  • Podiatrist
  • Rockville Centre, NY
  • NPI 1053267369
  NPD (past)

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

• Huntington Artificial Kidney Center LTD

  dba Freeport Kidney Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Freeport, NY
  • NPI 1740216159

  Dialysis facility

  Care Compare affiliation Name & address match
• Mercy Medical Center

  • Psychiatric Hospital Unit
  • Rockville Centre, NY
  • NPI 1427017854
  Care Compare affiliation
• Mercy Medical Center

  • Rehabilitation Hospital Unit
  • Rockville Centre, NY
  • NPI 1598724924
  Care Compare affiliation
• Mercy Medical Center

  • General Acute Care Hospital
  • Rockville Centre, NY
  • NPI 1659330173
  Care Compare affiliation
• South Nassau Communities Hospital

  • General Acute Care Hospital
  • Oceanside, NY
  • NPI 1922079094
  Care Compare affiliation
• Wsnchs North, Inc.

  dba St. Joseph Hospital

  • General Acute Care Hospital
  • Bethpage, NY
  • NPI 1013998426
  Care Compare affiliation

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1881804664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PETTIT AVENUE",
            "address_2": "SUITE 4",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "11710",
            "telephone_number": "516-409-0106",
            "fax_number": "516-409-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PETTIT AVENUE",
            "address_2": "SUITE 4",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "11710",
            "telephone_number": "516-409-0106",
            "fax_number": "516-409-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON DUBS",
        "first_name": "KELLY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "232457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Goldman, LCSW
• Amy Grossman Goldstein, CCC/SLP
• Juan P Gonzalez, MD
• Michael Goodman, MD
• Michael M Goodman, D.C.
• Albert H Gordon
• Shacora Tawanna Gordon
• Eric T Gott, DMD
• David Grand, L.C.S.W.
• Angela Grant

• Nephrology Physician in Bellmore, NY
• Providers in Bellmore, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.