Niyazi Kilic
Individual provider Active NPI Obstetrics & Gynecology Physician · Bethlehem, PA
NPI 1972096113 · NPPES record last updated Jun 12, 2018
Key facts
- NPI
- 1972096113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- MT216227 (PA)
- Practice address
- 801 Ostrum St
Bethlehem, PA 18015-1000 - Phone
- (484) 526-4670
- NPI assigned
- Jun 12, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vicksburg Clinic LLC
Practice addresses (Care Compare)
2100 Hwy 61 N
Vicksburg, MS 39183-8211
Phone (601) 883-5000
2200 Hwy 61 N
Vicksburg, MS 39183-8246
Hospital & facility affiliations
- Merit Health River Region
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.07 of 100
- Quality
- 73.89
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220809002256 | MS | Practitioner - Obstetrics/Gynecology | 1951783802 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT216227 | PA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vicksburg Clinic LLC | Current |
Accepting new patients | |
| Vicksburg Healthcare LLC | Past | Accepting new patients | |
| Vicksburg Clinic LLC | Obstetrics & Gynecology | Past | Accepting new patients |
| Vicksburg Clinic LLC | Past | Accepting new patients |
Locations
2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001
104 McAuley Dr
Vicksburg, MS 39183
Phone (601) 638-7271
801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200
Interoperability endpoints
- niyazi.kilic.1@1475.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MT216227 | PA | Yes |
Addresses
Primary practice location
801 Ostrum St
Bethlehem, PA 18015-1000
Mailing address
801 Ostrum St
Bethlehem, PA 18015-1000
Phone (484) 526-4670
NPI Registry JSON
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528761600000",
"number": "1972096113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 OSTRUM ST",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180151000",
"telephone_number": "484-526-4670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 OSTRUM ST",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180151000",
"telephone_number": "484-526-4670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILIC",
"first_name": "NIYAZI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-12",
"last_updated": "2018-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "PA",
"license": "MT216227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethlehem, PA
- Kidspeace National Centers, Inc
- Kidspeace National Centers, Inc.
- John Kidwell
- Alexander Kieffer
- Cheryl Lee Kienzle
- Nancy Ann Killackey
- Kirsten S Killion
- Ajin Kim
- Bright Kim
- Emilie Soyeon Kim
All providers in Bethlehem, PA · Obstetrics & Gynecology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.