Individual provider Active NPI

Kreangkai Tyree, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Altamonte Springs, FL
National Provider Identifier
1073584231
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
ME120573 Issued in FL
Practice address
601 E Altamonte Dr
Altamonte Springs, FL 32701-4802
Phone
(407) 303-2528
Fax
(407) 303-2760
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X ME120573 FL Primary
Pediatrics Physician 208000000X MD.024437 LA

Addresses

Primary practice location

601 E Altamonte Dr
Altamonte Springs, FL 32701-4802

Mailing address

2501 N Orange Ave Ste 446
Orlando, FL 32804-4644
Phone (407) 303-2528

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
I20170814002867 FL Practitioner - Pediatric Medicine 6709158520 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.024437LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Jul 24, 2017 Accepting new patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Jul 24, 2017 Accepting new patients

Locations

601 E Altamonte Dr
Altamonte Springs, FL 32701
Phone (407) 303-2200

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 446
Orlando, FL 32804
Phone (407) 975-0412

Interoperability endpoints

  • Direct secure messaging: ktyree71355@epicdirect.hf.org
  • Direct secure messaging: ktyree71405@adventhealth.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073584231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 446",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044644",
            "telephone_number": "407-303-2528",
            "fax_number": "407-303-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ALTAMONTE DR",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014802",
            "telephone_number": "407-303-2528",
            "fax_number": "407-303-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYREE",
        "first_name": "KREANGKAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "ME120573",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.024437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.