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KEVIN ANDREW DOUGLAS DPM
NPI 1174020598
Podiatrist - Foot & Ankle Surgery in Coram, NY

Active since April 11, 2018PECOS EnrolledAccepts Medicare Assignment
84.47/100
CMS Quality Rating
100 MIDDLE COUNTRY RD, CORAM, NY 11727(631) 696-9636(631) 696-9635 Get Directions Write a Review

NPPES record last updated: June 6, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 6, 2022, Sep 21, 2021, Apr 11, 2018 (3 updates tracked since 2018).

About Kevin Andrew Douglas Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN ANDREW DOUGLAS DPM (NPI 1174020598) is an individual foot & ankle surgery provider in Coram, New York, licensed in New York (N007168) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, is affiliated with Long Island Community Hospital, and is a graduate of New York College Of Podiatric Medicine (2018).

NPPES Registry Identity

NPI1174020598
Entity TypeIndividualMale
Primary Taxonomy213ES0103X
Provider Legal NameKEVIN ANDREW DOUGLASCredential: DPM
Location Address100 MIDDLE COUNTRY RDCoram, NY 11727-4412
Mailing Address1000 Montauk HwyWest Islip, NY 11795-4927 · Fax (631) 376-3420
Phone(631) 696-9636
Fax(631) 696-9635
Sole ProprietorNo
Medical School CMSNew York College Of Podiatric MedicineGraduated 2018
Enumeration DateApril 11, 2018
Last NPPES UpdateJune 6, 20223 updates tracked since enumeration
NPPES CertifiedJune 6, 2022
✔ NPI 1174020598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in NY · N007168
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
100 MIDDLE COUNTRY RD, Coram, NY 11727
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin Andrew Douglas Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476891797
PECOS Enrollment IDI20210825002298
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
295 services134 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
151 services151 patients
Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
106 services58 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
41 services17 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
27 services27 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
24 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Long Island Community Hospital

Acute Care Hospitals · Patchogue, NY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330141
Location101 Hospital RoadPatchogue, NY 11772 · Suffolk County
Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.33
Promoting Interoperability100
Improvement Activities40
Cost54.91

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LONGWOOD FOOT CARE, P.C.
Podiatrist (Foot Surgery)
100 MIDDLE COUNTRY RD
CORAM, NY 11727
Suffolk County (631) 696-9636
DR. DANIEL E STERN D.P.M.
Podiatrist
100 MIDDLE COUNTRY RD
CORAM, NY 11727
Suffolk County (631) 696-9636
DR. CHRISTINE B STERN D.P.M.
Podiatrist (Foot Surgery)
100 MIDDLE COUNTRY RD
CORAM, NY 11727
Suffolk County (631) 696-9636
CORAM PODIATRY PLLC
Podiatrist
100 MIDDLE COUNTRY RD
CORAM, NY 11727
Suffolk County (631) 696-9636

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Douglas's NPI number?

The NPI number for Kevin Douglas is 1174020598. It was assigned to this individual provider in the NPPES registry on April 11, 2018.

Where is Kevin Douglas located?

Kevin Douglas practices at 100 Middle Country Rd, Coram, NY 11727. The listed phone number is (631) 696-9636.

What is Kevin Douglas's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Kevin Douglas enrolled in Medicare?

Yes. Kevin Douglas is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Kevin Douglas affiliated with any hospitals?

According to CMS data, Kevin Douglas is affiliated with Long Island Community Hospital.

When was this NPI record last updated?

The NPPES record for Kevin Douglas was last updated on June 6, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.