Kristin Marie Didomenico, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD451396 Issued in PA

Practice address

601 Walnut St Ste 210W
Philadelphia, PA 19106-3323

Phone

(215) 925-6402

Fax

(215) 925-0262

NPI assigned

Jun 2, 2010

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 names 1

• Kristin Marie Doyle Former name

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

Ophthalmology

Education

Jefferson Medical College of Thomas Jefferson University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kay and Tabas OphthalmologyGroup PAC ID 7315848991, 9 clinicians

Wills Eye Ophthalmology Clinic, IncGroup PAC ID 9133025166, 146 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.81 of 100Reported as group

Quality

93.76

Promoting interoperability

93

Improvement activities

40

Cost

78.11

Merit-based Incentive Payment System (MIPS)

Final score

87.34 of 100Reported as group

Quality

80.85

Promoting interoperability

100

Improvement activities

40

Cost

76.95

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Kay & Tabas Ophthalmology Associates

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1386647105
  Medicare reassignment Care Compare group NPD
• Wills Eye Ophthalmology Clinic, Inc

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1184624009
  Medicare reassignment Care Compare group NPD
• Vantage Eyecare, LLC

  • Durable Medical Equipment & Medical Supplies
  • Bala Cynwyd, PA
  • NPI 1023580131
  NPD (past)

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1992025985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WALNUT ST STE 210W",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063323",
            "telephone_number": "215-925-6402",
            "fax_number": "215-925-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WALNUT ST STE 210W",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063323",
            "telephone_number": "215-925-6402",
            "fax_number": "215-925-0262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Monument Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Bala Cynwyd",
            "state": "PA",
            "postal_code": "190041706",
            "country_code": "US",
            "telephone_number": "610-667-6760",
            "fax_number": "610-667-7206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIDOMENICO",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD451396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "DOYLE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Corey Dickson
• Rebecca Ann Dicondina, MS
• Marisha Dicrecchio, MSN, CRNP, PMHNP-BC
• John Wesley Diddle, MD
• Concetta Didomenico, PNP-BC
• Laura Michele Didomenico, M.D.
• Angelarosa Didonato, CRNA
• Liezl Rasgo Didonato, CRNP
• Brendon L Didonna, PAC
• Lilliana Didovic, MA

• Ophthalmology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.