Individual provider Active NPI

Kristopher Jacques Paultre, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Miami, FL
National Provider Identifier
1114381118
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
ME137411 Issued in FL
Practice address
13707 SW 152ND St
Miami, FL 33177-1106
Phone
(305) 585-9200
NPI assigned
Apr 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME137411 FL
Student in an Organized Health Care Education/Training Program 390200000X FL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X ME137411 FL Primary

Addresses

Primary practice location

13707 SW 152ND St
Miami, FL 33177-1106

Mailing address

1111 SW 1St Ave Apt 2620
Miami, FL 33130-5408
Phone (954) 732-8726

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
I20190724001918 FL Practitioner - Family Practice 3476889759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1453 NW 9TH Ave
Miami, FL 33136
Phone (305) 243-7090

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Jul 3, 2020 Accepting new patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Jul 3, 2020 Accepting new patients
Public Health Trust of Miami Dade County Florida Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kpaultre42717@direct.med.miami.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1114381118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SW 1ST AVE APT 2620",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331305408",
            "telephone_number": "954-732-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13707 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771106",
            "telephone_number": "305-585-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULTRE",
        "first_name": "KRISTOPHER",
        "middle_name": "JACQUES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME137411",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME137411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.