Individual provider Active NPI

Kwame Safo Ntim, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Cloud, FL
National Provider Identifier
1194926501
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME114943 Issued in FL
Practice address
3004 17TH St
Saint Cloud, FL 34769-6011
Phone
(407) 593-2910
Fax
(407) 593-2913
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME114943 FL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME114943 FL Primary

Addresses

Primary practice location

3004 17TH St
Saint Cloud, FL 34769-6011

Mailing address

3004 17TH Street
St Cloud, FL 34769
Phone (407) 593-2910

Other identifiers 1

IdentifierTypeStateIssuer
008982700MedicaidFL

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
I20130731000053 FL Practitioner - Endocrinology 6800911801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Endocrinology PLLCGroup PAC ID 9234396326, 4 clinicians

Practice addresses (Care Compare)

3004 17TH St
Saint Cloud, FL 34769-6011
Phone 4075932910101

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health St Cloud Hospital Hospital, Saint Cloud, FL, CCN 100302
  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME114943FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Endocrinology PLLC Endocrinology, Diabetes & Metabolism CurrentSince Jul 1, 2015 Accepting new patients
Elite Endocrine and Metabolism Care LLC Endocrinology, Diabetes & Metabolism Current Accepting new patients

Locations

3004 17th St
Saint Cloud, FL 34769
Phone (407) 556-3973

2914 17th St
Saint Cloud, FL 34769
Phone (407) 498-3076

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBFHBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBFHBA/Endpoint/FBFHBA

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.

Hospital & facility affiliations 4

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1194926501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 17TH STREET",
            "city": "ST CLOUD",
            "state": "FL",
            "postal_code": "34769",
            "telephone_number": "407-593-2910",
            "fax_number": "407-593-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696011",
            "telephone_number": "407-593-2910",
            "fax_number": "407-593-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NTIM",
        "first_name": "KWAME",
        "middle_name": "SAFO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME114943",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME114943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008982700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.