Organization Active NPI

Richard D Kimmel DO FCCP PA

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Boca Raton, FL
National Provider Identifier
1316909278
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
OS 6191 Issued in FL
Legal business name
RICHARD D KIMMEL DO FCCP PA
Practice address
9980 Central Park Blvd N
Suite 316
Boca Raton, FL 33428-1762
Phone
(561) 477-0210
Fax
(561) 470-0198
NPI assigned
Apr 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Authorized official

Name
Richard D Kimmel, DO FCCP PANPI 1740335017
Title
Physician
Phone
(561) 477-0210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X OS 6191 FL Primary

Addresses

Primary practice location

9980 Central Park Blvd N
Suite 316
Boca Raton, FL 33428-1762

Mailing address

9980 Central Park Blvd N
Suite 316
Boca Raton, FL 33428-1762
Phone (561) 477-0210

Other identifiers 1

IdentifierTypeStateIssuer
057435000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070322000271 FL Part B Supplier - Clinic/Group Practice 3870697386 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Locations

1905 Clint Moore Rd
Ste 215
Boca Raton, FL 33496
Phone (561) 477-0210

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1316909278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 CENTRAL PARK BLVD N",
            "address_2": "SUITE 316",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281762",
            "telephone_number": "561-477-0210",
            "fax_number": "561-470-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9980 CENTRAL PARK BLVD N",
            "address_2": "SUITE 316",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281762",
            "telephone_number": "561-477-0210",
            "fax_number": "561-470-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD D KIMMEL DO FCCP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "561-477-0210",
        "authorized_official_credential": "DO FCCP PA"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "OS 6191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057435000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.