JULIE THOMAS KIDANGAN (DO) – Family Medicine Physician, NPI 1437470119

JULIE THOMAS KIDANGAN (DO) is a healthcare provider. based in Boston, Massachusetts. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 25MB09393100 (NJ). The NPI Number for JULIE THOMAS KIDANGAN (DO) is 1437470119

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
JULIE THOMAS KIDANGAN (DO)
NPI
1437470119
Phone
(201) 666-3900
Address
PO BOX 419430
Enumeration Date
17 June 2010
Last Update Date
25 April 2017

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Secondary Phone
9739426005
Graduation Year
2010 (16 years ago)
PAC ID
0042440729
Group Practice PAC ID
0345299947
Professional Enrollment ID
I20140225000259
Address ID
NJ074702033WA510XXTPKE301
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

2,512 FAMILY PRACTICE in NJ

Provider Addresses for JULIE THOMAS KIDANGAN (DO)

  • PO BOX 419430

    BOSTON, MA 022419430

    Phone: (201) 666-3900

    Fax: (201) 261-0505

    Type: Mailing

  • 1310 BROAD ST

    BLOOMFIELD, NJ 070033010

    Phone: (973) 338-0935

    Fax: (973) 338-1097

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-02-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140225000259IFamily PracticeNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes17577$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit4040$0
99215Established patient office or other outpatient visit, 40-54 minutes3624$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report3434$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage2424$0
View full utilization report →

Insurance plans in this area (ZIP 02241)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345299947View full group profile

Reviews

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Frequently asked questions

What is JULIE THOMAS KIDANGAN (DO)'s NPI number?
JULIE THOMAS KIDANGAN (DO)'s NPI is 1437470119 — the number used across U.S. healthcare to identify this provider.
Would JULIE THOMAS KIDANGAN (DO) appear as active to a payer?
You can treat JULIE THOMAS KIDANGAN (DO) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for JULIE THOMAS KIDANGAN (DO)?
At a glance, JULIE THOMAS KIDANGAN (DO) is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is JULIE THOMAS KIDANGAN (DO) located near Boston?
JULIE THOMAS KIDANGAN (DO) currently maps to Boston, Massachusetts in this extract.
Does JULIE THOMAS KIDANGAN (DO) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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