Kathleen Louise Peditto, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME63190 Issued in FL

Practice address

3251 N McMullen Booth Rd
Suite 103
Clearwater, FL 33761-2022

Phone

(727) 799-6385

Fax

(813) 635-7863

NPI assigned

May 18, 2006

Last updated

Apr 23, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Baycare Medical Group, Inc.

  • General Practice Physician
  • Clearwater, FL
  • NPI 1043269871

  Internal Medicine

  Medicare reassignment NPD
• Baycare Medical Group, Inc.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1659720837
  NPD

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1114970670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10744",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337578744",
            "telephone_number": "727-532-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 N MCMULLEN BOOTH RD",
            "address_2": "SUITE 103",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612022",
            "telephone_number": "727-799-6385",
            "fax_number": "813-635-7863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDITTO",
        "first_name": "KATHLEEN",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME63190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "110221224",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251779500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Florida, Inc
• Michelle Lee Pedigo, B.S.
• Pedorthic Office - Footwear & Orthotics, LLC
• Pamela J Pedroncelli, APRN
• Carisa Dawnyeill Peeples, PMHNP
• Ratna Ravi Teja Peesapati, PHARM.D
• Samuel Peillon

• Internal Medicine Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.