Kelly Renee Paeth, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11001821 Issued in FL

Practice address

106 Boston Ave Ste 205
Altamonte Springs, FL 32701-4712

Phone

(407) 212-9532

NPI assigned

Mar 20, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  TN

  Medicare reassignment

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1043770803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 LEGACY CLUB DR",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517528",
            "telephone_number": "407-455-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BOSTON AVE STE 205",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014712",
            "telephone_number": "407-212-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAETH",
        "first_name": "KELLY",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Pacheco
• Carolina Pacheco
• Deidre M Padilla
• Kayla Padilla
• Sheila Padron Lopez, RBT
• Danny Javiel Paez Vigoa
• Lourdes Paez, OTRL
• Tina M Pagan
• William Joel Pagan
• Wesley Jermaine Page, OTR

• Family Nurse Practitioner in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.