Active NPI
Kenneth A Ciardiello, MD
- Surgery Physician
- Naples, FL
National Provider Identifier
1184719395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME134560
- Practice address
- 6400 Davis Blvd Ste 104
Naples, FL 34104-5321 - Phone
- (239) 624-0650
- Fax
- (239) 624-0651
- NPI assigned
- Oct 4, 2006
- Last updated
- Dec 30, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME134560 | FL | Primary |
Addresses
Primary practice location
6400 Davis Blvd Ste 104
Naples, FL 34104-5321
Mailing address
6400 Davis Blvd Ste 104
Naples, FL 34104-5321
Phone (239) 624-0650
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004096550 | Medicaid | CT | |
| 100801100 | Medicaid | FL | |
| 31AWY | Other | FL | BCBS |
| KG508 | Other | FL | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Raphael Faculty Physicians | Surgery | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546128000000",
"number": "1184719395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 DAVIS BLVD STE 104",
"city": "NAPLES",
"state": "FL",
"postal_code": "341045321",
"telephone_number": "239-624-0650",
"fax_number": "239-624-0651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 DAVIS BLVD STE 104",
"city": "NAPLES",
"state": "FL",
"postal_code": "341045321",
"telephone_number": "239-624-0650",
"fax_number": "239-624-0651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIARDIELLO",
"first_name": "KENNETH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2018-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME134560",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004096550",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100801100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "31AWY",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "KG508",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.