Individual provider Active NPI

Robert Anthony Kickish Jr.

  • Pediatrics Physician
  • Clearwater, FL
National Provider Identifier
1316280167
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME126742 Issued in FL
Practice address
14100 58TH St N
Clearwater, FL 33760-9900
Phone
(727) 824-8181
Fax
(727) 824-8165
NPI assigned
Mar 30, 2013
Last updated
May 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME126742 FL Primary

Addresses

Primary practice location

14100 58TH St N
Clearwater, FL 33760-9900

Mailing address

2995 Drew St
Clearwater, FL 33759-3012
Phone (727) 281-9065

Other practice location 1

14100 58th St N
Clearwater, FL 33760-9900
Phone (727) 824-8181

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Robert.KickishMD@direct.mybaycare.org Direct BayCare Medical Group, 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
I20190515000359 FL Practitioner - Pediatric Medicine 8123361144 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME126742FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Current Accepting new patients
Community Health Centers of Pinellas Inc. CurrentSince May 20, 2019 Accepting new patients
Community Health Center of Pinellas Inc Current Accepting new patients
Baycare Medical Group, Inc. CurrentSince Dec 8, 2024 Accepting new patients
Community Health Centers of Pinellas Inc. CurrentSince May 20, 2019 Accepting new patients

Locations

14100 58th St N
Clearwater, FL 33760

14100 58th St N
Ste 100
Clearwater, FL 33760
Phone (727) 286-6224

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

7550 43rd St N
Pinellas Park, FL 33781
Phone (727) 290-4222

1344 22nd St S
St Petersburg, FL 33712
Phone (727) 821-6701

4950 34th St N
St Petersburg, FL 33714

1919 W Swann Ave
Fl 2
Tampa, FL 33606
Phone (813) 254-7078

Interoperability endpoints

  • Direct secure messaging: robert.kickishmd@direct.mybaycare.org

Organizations & group practices 5

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": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1316280167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-281-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14100 58th St N",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337609900",
            "country_code": "US",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KICKISH",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-30",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME126742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Robert.KickishMD@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14100 58th St N",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337609900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.