Daniel Gene Kolder, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

T2004016415 Issued in MO

Practice address

2460 N Ponderosa Dr Ste A117
Camarillo, CA 93010-2468

Phone

(805) 484-2855

Fax

(805) 389-1245

NPI assigned

Oct 2, 2006

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Plastic and Reconstructive Surgery

Education

Creighton University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: dkolder@directaddress.net
• Direct secure messaging: dgkolder@directaddress.net

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.

• Camarillo Surgical Center Associates Inc

  • Ambulatory Surgical Clinic/Center
  • Camarillo, CA
  • NPI 1801230719
  Medicare reassignment NPD Authorized official
• Daniel Gene Kolder, M.D. a California Professional Corporation

  • Plastic Surgery Physician
  • Camarillo, CA
  • NPI 1598006652
  Medicare reassignment NPD Authorized official
• Pacifica Dermatology

  • Dermatology Physician
  • Camarillo, CA
  • NPI 1497392492
  NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1942393053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 N PONDEROSA DR STE A117",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102468",
            "telephone_number": "805-484-2855",
            "fax_number": "805-389-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 N PONDEROSA DR STE A117",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102468",
            "telephone_number": "805-484-2855",
            "fax_number": "805-389-1245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2460 N Ponderosa Dr Ste A116",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930102468",
            "country_code": "US",
            "telephone_number": "805-484-2855",
            "fax_number": "805-389-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLDER",
        "first_name": "DANIEL",
        "middle_name": "GENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "T2004016415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Knoll Psychology Inc
• Brian Knoll
• Elyse Kiele Koe, PA-C
• Negar Kohandarvish, DDS
• Stephanee Kohler
• Rebeka Kolevski
• Ashley Nicole Koning, M.S. SLP
• Andrea Koontz
• Erin Korner
• Mina Nicole Korpontinos, BA

• Surgery Physician in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.