Individual provider Active NPI

Steven Lee Kanner, DO

  • Internal Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1053306969
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
054485 Issued in FL
Practice address
2051 45TH St Ste 303
West Palm Beach, FL 33407-2031
Phone
(561) 863-8301
Fax
(615) 459-1712
NPI assigned
Sep 16, 2005
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 054485 FL Primary

Addresses

Primary practice location

2051 45TH St Ste 303
West Palm Beach, FL 33407-2031

Mailing address

2051 45TH St Ste 303
West Palm Beach, FL 33407-2031
Phone (561) 863-8301

Other identifiers 1

IdentifierTypeStateIssuer
060686300MedicaidFL

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
I20040408001173 FL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4981698420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2051 45TH St
Suite 303
West Palm Beach, FL 33407-2031
Phone (561) 863-8301

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4485FLMDAcupuncturist
054485FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steven Kanner DO PLLC Internal Medicine CurrentSince Sep 3, 2013 Accepting new patients

Locations

2051 45th St
Ste 303
West Palm Beach, FL 33407
Phone (561) 863-8301

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: steven.kanner@109.emedpractice.direct-ci.com

Organizations & group practices 1

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 4

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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1053306969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 45TH ST STE 303",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072031",
            "telephone_number": "561-863-8301",
            "fax_number": "561-459-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 45TH ST STE 303",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072031",
            "telephone_number": "561-863-8301",
            "fax_number": "615-459-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNER",
        "first_name": "STEVEN",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "054485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060686300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.