Individual provider Active NPI

Renu Khode, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Naples, FL
National Provider Identifier
1043556475
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME114635 Issued in FL
Practice address
6101 Pine Ridge Rd
Naples, FL 34119-3900
Phone
(239) 304-4969
Fax
(239) 304-5087
NPI assigned
Dec 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME114635 FL Primary

Addresses

Primary practice location

6101 Pine Ridge Rd
Naples, FL 34119-3900

Mailing address

5755 Hoover Blvd
Tampa, FL 33634-5340
Phone (813) 490-7206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20130205000353 FL Practitioner - Pathology 0345494043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

119 Oakfield Dr
Brandon, FL 33511-5779
Phone (813) 571-5193

Hospital & facility affiliations

  • HCA Florida Brandon Hospital Hospital, Brandon, FL, CCN 100243
  • HCA Florida Trinity Hospital Hospital, Trinity, FL, CCN 100191
  • HCA Florida Blake Hospital Hospital, Bradenton, FL, CCN 100213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME114635FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Jun 1, 2019 Accepting new patients
Adventist Health System-Sunbelt Inc Past Accepting new patients

Locations

119 Oakfield Dr
Brandon, FL 33511
Phone (813) 571-5150

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1043556475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 HOOVER BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345340",
            "telephone_number": "813-490-7206",
            "fax_number": "813-886-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 PINE RIDGE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193900",
            "telephone_number": "239-304-4969",
            "fax_number": "239-304-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODE",
        "first_name": "RENU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-12",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME114635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.