Individual provider Active NPI

William J Kaiser, MD

  • Vascular Surgery Physician
  • Pensacola, FL
National Provider Identifier
1003883612
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME146721 Issued in FL
Practice address
5149 N 9TH Ave Ste 120
Pensacola, FL 32504-8734
Phone
(850) 479-1805
Fax
(850) 479-1829
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 034166 GA
Vascular Surgery Physician 2086S0129X ME146721 FL Primary

Addresses

Primary practice location

5149 N 9TH Ave Ste 120
Pensacola, FL 32504-8734

Mailing address

PO Box 11982
Pensacola, FL 32524-1982
Phone (850) 479-1805

Other practice location 1

1007 Greenfield Dr
Tifton, GA 31794-3795
Phone (229) 382-9733

Other practice location 2

1641 Madison Ave
Tifton, GA 31794-3757
Phone (229) 353-2284

Other identifiers 2

IdentifierTypeStateIssuer
205810921BMedicaidGA
205810921AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060518000107 GA Practitioner - General SurgeryPractitioner - Vascular Surgery 0941211478 Reassigns benefits to 2 organizations
I20201116001211 FL Practitioner - Vascular SurgeryPractitioner - General Surgery 0941211478

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
New York Medical College, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tift Regional Health System IncGroup PAC ID 2062745169, 294 clinicians

Practice addresses (Care Compare)

1641 Madison Ave
Tifton, GA 31794-3757
Phone (229) 535-2285

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.02 of 100Reported as group
Quality
57.87
Promoting interoperability
100
Improvement activities
40
Cost
75.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)23
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince Apr 1, 2006 Accepting new patients
Tift Regional Health System Inc CurrentSince Aug 1, 2019 Accepting new patients
Douglas Vascular Center, LLC CurrentSince Feb 12, 2012 Accepting new patients
Tift Regional Health System Inc Current Accepting new patients
Tift Regional Health System Inc Vascular Surgery Current Accepting new patients
Tift Regional Health System Inc CurrentSince Apr 1, 2006 Accepting new patients
Tift Regional Health System Inc. Past Accepting new patients

Locations

3001 Palm Harbor Blvd
Ste A
Palm Harbor, FL 34683

260 Mj Taylor Rd
Adel, GA 31620
Phone (229) 247-2290

326 Shirley Ave
Douglas, GA 31533
Phone (404) 606-2069

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

1622 Madison Ave
Tifton, GA 31794
Phone (229) 387-8061

1641 Madison Ave
Tifton, GA 31794
Phone (229) 353-2284

907 18th St E
Ste 400
Tifton, GA 31794

1007 Greenfield Dr
Tifton, GA 31794
Phone (229) 382-9733

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

Interoperability endpoints

  • Direct secure messaging: william.kaiser@trhs.cernerdirect.com
  • Direct secure messaging: wkaiser@cvi.curemd.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1003883612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11982",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325241982",
            "telephone_number": "850-479-1805",
            "fax_number": "850-479-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5149 N 9TH AVE STE 120",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048734",
            "telephone_number": "850-479-1805",
            "fax_number": "850-479-1829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Greenfield Dr",
            "address_purpose": "LOCATION",
            "city": "Tifton",
            "state": "GA",
            "postal_code": "317943795",
            "country_code": "US",
            "telephone_number": "229-382-9733",
            "fax_number": "229-387-6161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1641 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Tifton",
            "state": "GA",
            "postal_code": "317943757",
            "country_code": "US",
            "telephone_number": "229-353-2284",
            "fax_number": "229-353-2284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAISER",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "034166",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME146721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205810921B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205810921A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.