Individual provider Active NPI

Paul Kleidermacher, M.D.

  • Otolaryngology Physician
  • Miami, FL
National Provider Identifier
1184624561
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME72803 Issued in FL
Practice address
1330 Coral Way Ste 403
Miami, FL 33145-2945
Phone
(305) 325-0090
Fax
(305) 325-0082
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Otolaryngology) Physician 207YS0012X ME72803 FL
Otolaryngology Physician 207Y00000X ME72803 FL Primary

Addresses

Primary practice location

1330 Coral Way Ste 403
Miami, FL 33145-2945

Mailing address

15280 NW 79TH CT Ste 200
Miami Lakes, FL 33016-5873
Phone (305) 558-3724

Other identifiers 1

IdentifierTypeStateIssuer
2542668000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address paulkleidermacher@sfa.allscriptsdirect.net South Florida ENT Associates, Inc.

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
I20100326000439 FL Practitioner - Otolaryngology 4082780416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Jefferson Medical College of Thomas Jefferson University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida ENT Associates IncGroup PAC ID 4587556923, 156 clinicians

Practice addresses (Care Compare)

21097 NE 27TH CT
Suite 410
Aventura, FL 33180-1249
Phone (305) 932-6375

Hospital & facility affiliations

  • Mount Sinai Medical Center of Florida, Inc Hospital, Miami Beach, FL, CCN 100034
  • HCA Florida Aventura Hospital Hospital, Aventura, FL, CCN 100131

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME72803FLMDSleep Medicine (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida ENT Associates, Inc. Otolaryngology CurrentSince Jan 1, 2002 Accepting new patients

Locations

21097 NE 27th Ct
Ste 410
Aventura, FL 33180
Phone (305) 932-6375

747 Ponce de Leon Blvd
Ste 305
Coral Gables, FL 33134
Phone (305) 444-4903

1330 SW 22nd St
Ste 403
Miami, FL 33145
Phone (305) 325-0090

1321 NW 14th St
Ste 204
Miami, FL 33125
Phone (305) 325-0090

8940 N Kendall Dr
Ste 504E
Miami, FL 33176
Phone (305) 595-6200

8181 NW 154th St
Ste 200
Miami Lakes, FL 33016
Phone (225) 298-3537

15280 NW 79th Ct
Ste 200
Miami Lakes, FL 33016

1801 NE 123rd St
Ste 315
North Miami, FL 33181
Phone (786) 507-4151

18501 Pines Blvd
Ste 210
Pembroke Pines, FL 33029
Phone (954) 237-2505

Interoperability endpoints

  • Direct secure messaging: paulkleidermacher@sfa.allscriptsdirect.net

Organizations & group practices 1

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": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1184624561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT STE 200",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165873",
            "telephone_number": "305-558-3724",
            "fax_number": "786-907-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 CORAL WAY STE 403",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331452945",
            "telephone_number": "305-325-0090",
            "fax_number": "305-325-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIDERMACHER",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "FL",
            "license": "ME72803",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME72803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2542668000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paulkleidermacher@sfa.allscriptsdirect.net",
            "affiliation": "Y",
            "affiliationName": "South Florida ENT Associates, Inc.",
            "address_1": "1330 Coral Way Ste 403",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331452945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.