Individual provider Active NPI

Kevin Joseph Kokesh

  • Student in an Organized Health Care Education/Training Program
  • Orlando, FL
National Provider Identifier
1134657992
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
60 W Gore St
Orlando, FL 32806-1141
Phone
(321) 841-6350
Fax
(321) 841-6355
NPI assigned
May 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

60 W Gore St
Orlando, FL 32806-1141

Mailing address

60 W Gore St
Orlando, FL 32806-1141
Phone (321) 841-6350

Other practice location 1

PO Box 100296
Gainesville, FL 32610-0296
Phone (352) 273-8466

Other identifiers 1

IdentifierTypeStateIssuer
124101300MedicaidFL

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
I20240923002925 FL Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 5698049062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Pulmonary Disease
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

60 W Gore St
Orlando, FL 32806-1141
Phone (407) 423-1039

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2024 Accepting new patients

Locations

60 W Gore St
Orlando, FL 32806
Phone (321) 841-3338

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

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": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1134657992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061141",
            "telephone_number": "321-841-6350",
            "fax_number": "321-841-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061141",
            "telephone_number": "321-841-6350",
            "fax_number": "321-841-6355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 100296",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326100296",
            "country_code": "US",
            "telephone_number": "352-273-8466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOKESH",
        "first_name": "KEVIN",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124101300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.