Active NPI
Kenneth Paul Boccaccio, PA-C
- Physician Assistant
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 102296
- Practice address
- 12880 Commodity Place
Tampa, FL 33626-3101 - Phone
- (813) 343-5500
- Fax
- (813) 343-5506
- NPI assigned
- Jun 23, 2006
- Last updated
- Jan 3, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 102296 | NC | Primary |
Addresses
Primary practice location
12880 Commodity Place
Tampa, FL 33626-3101
Mailing address
PO Box 21724
Tampa, FL 33622-1724
Phone (813) 343-5500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duke Health Integrated Practice, Inc. | Current | Accepting new patients | |
| Duke Health Integrated Practice, Inc | Current | Accepting new patients |
Locations
40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588
3400 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 954-3000
4101 Macon Pond Rd
Raleigh, NC 27607
Phone (919) 781-7070
Interoperability endpoints
- kboccaccio196242@direct.medicine.duke.edu
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Physician
- Durham, NC
- NPI 1205553369
-
dba Central Carolina Foot and Ankle
- Orthopaedic Foot and Ankle Surgery Physician
- Durham, NC
- NPI 1518725936
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Duke Raleigh Hospital, a campus of Duke University Hospital
- Rehabilitation Hospital Unit
- Raleigh, NC
- NPI 1205225646
-
dba Duke Raleigh Hospital, a campus of Duke University Hospital
- Clinical Medical Laboratory
- Raleigh, NC
- NPI 1306828108
Hospital
-
dba Duke University Hospital
- Clinical Medical Laboratory
- Durham, NC
- NPI 1508847047
Hospital
-
dba Duke University Hospital
- Land Ambulance
- Durham, NC
- NPI 1417954942
Hospital
-
dba Duke University Hospital
- Rehabilitation Hospital Unit
- Durham, NC
- NPI 1538166061
-
dba Duke University Hospital
- General Acute Care Hospital
- Durham, NC
- NPI 1992703540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325548800000",
"number": "1194751255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21724",
"city": "TAMPA",
"state": "FL",
"postal_code": "336221724",
"telephone_number": "813-343-5500",
"fax_number": "813-343-5506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12880 COMMODITY PLACE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336263101",
"telephone_number": "813-343-5500",
"fax_number": "813-343-5506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCCACCIO",
"first_name": "KENNETH",
"middle_name": "PAUL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2012-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "102296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.