Individual provider Active NPI

Kenneth Cerreta, M.D.

  • Pulmonary Disease Physician
  • Clearwater, FL
National Provider Identifier
1093004160
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME131027 Issued in FL
Practice address
430 Morton Plant St Ste 405
Clearwater, FL 33756-3394
Phone
(727) 443-0611
Fax
(727) 461-5493
NPI assigned
Mar 29, 2011
Last updated
Aug 7, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME131027 FL Primary

Addresses

Primary practice location

430 Morton Plant St Ste 405
Clearwater, FL 33756-3394

Mailing address

430 Morton Plant St Ste 405
Clearwater, FL 33756-3394
Phone (727) 443-0611

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
I20170731001500 FL Practitioner - Pulmonary Disease 3173746823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Rutgers New Jersey Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians
Bay Area Chest Physicians P aGroup PAC ID 0941299010, 15 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

300 Pinellas St
Clearwater, FL 33756-3804
Phone (727) 461-8231

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone (727) 725-6526

430 Morton Plant St
Suite 405
Clearwater, FL 33756-3394
Phone (727) 443-0611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME131027FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Chest Physicians P a Pulmonary Disease CurrentSince Jul 15, 2017 Accepting new patients

Locations

616 E St
Clearwater, FL 33756
Phone (727) 443-0611

430 Morton Plant St
Ste 405
Clearwater, FL 33756
Phone (727) 443-0611

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEFFBA
  • Direct secure messaging: kenneth.cerreta@bacp.eclinicaldirectplus.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, 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": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1093004160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MORTON PLANT ST STE 405",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563394",
            "telephone_number": "727-443-0611",
            "fax_number": "727-461-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MORTON PLANT ST STE 405",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563394",
            "telephone_number": "727-443-0611",
            "fax_number": "727-461-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERRETA",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-29",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME131027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.