Douglas Kimmel, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS006506L Issued in PA

Practice address

23 Bustleton Pike
Suite 100
Feasterville Trevose, PA 19053-6446

Phone

(215) 464-9599

Fax

(215) 464-7865

NPI assigned

Sep 19, 2005

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 5

Electronic endpoints 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: douglas.kimmel.1@17399.direct.athenahealth.com

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.

• HR Physician Services

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  • Meadowbrook, PA
  • NPI 1881696698
  Medicare reassignment NPD
• HR Physician Services

  • Family Medicine Physician
  • Warminster, PA
  • NPI 1306183918
  NPD
• HR Physician Services

  • Internal Medicine Physician
  • Huntingdon Valley, PA
  • NPI 1679450910
  NPD

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1891780631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 HUNTINGDON PIKE",
            "address_2": "MEDICAL STAFF OFFICE 1ST FLR",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190468001",
            "telephone_number": "215-938-3450",
            "fax_number": "215-938-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BUSTLETON PIKE",
            "address_2": "SUITE 100",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190536446",
            "telephone_number": "215-464-9599",
            "fax_number": "215-464-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "DOUGLAS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006506L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "570038",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01767OS006506L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "0391404000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEATLHCARE",
            "identifier": "98765",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100416C",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "douglas.kimmel.1@17399.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "23 Bustleton Pike",
            "address_2": "Suite 100",
            "city": "Feasterville Trevose",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190536446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna Keylin
• Larisa Khalupsky, M.D.
• Darsaan K Khanna, MS
• Ruman U Khattak, DMD
• Ki Y Kim, RPH
• Svetlana Klichinsky
• Maciej Kosakowski, DMD
• Yasmeen Ktaishat
• Georgy Kurudimov, DMD
• Neelima M Kute, MD

• Family Medicine Physician in Feasterville Trevose, PA
• Providers in Feasterville Trevose, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.