Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin Andrew Douglas, DPM

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1174020598

Kevin Andrew Douglas, DPM is a Podiatry in Coram, New York. Graduated from New York College of Podiatric Medicine in 2018, 8 years ago. Practices with New York University, a 5,884-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Trained at
New York College of Podiatric Medicine
Licensed in
NY
In the registry since
2018
Specialties on file
2
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

100 Middle Country Rd
Coram, NY 11727-4412
Phone: (631) 696-9636
Fax: (631) 696-9635
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence N007168 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1174020598
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedApril 11, 2018
Last updated in NPPESJune 6, 2022
Certification dateJune 6, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolNEW YORK COLLEGE OF PODIATRIC MEDICINE
Graduated 2018 (8 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Coram