NPIMap

Individual provider Active NPI

Kenneth Manchon, MD

  • Internal Medicine Physician
  • Atlantis, FL
National Provider Identifier
1073569398
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME76072 Issued in FL
Practice address
130 JFK Dr Ste 130
Atlantis, FL 33462-1141
Phone
(561) 581-8496
Fax
(561) 581-8497
NPI assigned
May 26, 2006
Last updated
May 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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 ME76072 FL Primary

Addresses

Primary practice location

130 JFK Dr Ste 130
Atlantis, FL 33462-1141

Mailing address

7593 W Boynton Beach Blvd Ste 220
Boynton Beach, FL 33437-6162
Phone (561) 649-7000

Other practice location 1

10115 Forest Hill Blvd Ste 200
Wellington, FL 33414-3104
Phone (561) 581-8496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100416000376 FL Practitioner - Internal Medicine 2062549405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

107 JFK Dr
Suite B
Atlantis, FL 33462-1153
Phone (561) 295-6962

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Multispecialty Group of Florida LLC Internal Medicine CurrentSince May 18, 2025 Accepting new patients
Ca Medical Services Current Accepting new patients
Medical Specialists of the Palm Beaches Inc Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Medical Specialists of the Palm Beaches Inc Internal Medicine PastSince Feb 1, 2017 Accepting new patients

Locations

5401 S Congress Ave
Ste 105
Atlantis, FL 33462
Phone (561) 642-8500

7593 W Boynton Beach Blvd
Ste 220
Boynton Beach, FL 33437
Phone (561) 649-7000

9868 S State Road 7
Ste 325
Boynton Beach, FL 33472

10115 Forest Hill Blvd
Ste 200
Wellington, FL 33414
Phone (561) 793-5155

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Interoperability endpoints

  • Direct secure messaging: kenneth.manchon.1@11933.direct.athenahealth.com

Organizations & group practices 5

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 6

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1073569398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7593 W BOYNTON BEACH BLVD STE 220",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334376162",
            "telephone_number": "561-649-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 JFK DR STE 130",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621141",
            "telephone_number": "561-581-8496",
            "fax_number": "561-581-8497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10115 Forest Hill Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334143104",
            "country_code": "US",
            "telephone_number": "561-581-8496",
            "fax_number": "561-581-8497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCHON",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME76072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

Verify at the official NPI Registry.