Individual provider Active NPI

Michael J Kerkes, MD

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1316943905
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME44739 Issued in FL
Practice address
4614 S Kirkman Rd
Orlando, FL 32811-2891
Phone
(407) 512-5700
Fax
(800) 752-1493
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME44739 FL Primary

Addresses

Primary practice location

4614 S Kirkman Rd
Orlando, FL 32811-2891

Mailing address

4614 S Kirkman Rd
Orlando, FL 32811-2891
Phone (407) 512-5700

Other identifiers 7

IdentifierTypeStateIssuer
593516436003OtherTRICARE
7194953OtherMAMSI
773114OtherMAILHANDLERS
593516436OtherMEDICAL MUTUAL
47696OtherFLBCBS
695956OtherTUFTS
P00397528OtherRR GBA 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

State licenses

LicenseStateTypeSpecialty
ME44739FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet-Solantic Joint Venture LLC PastSince Nov 22, 2010 Accepting new patients
Florida Heart & Vascular Multi Specialty Group, PA Family Medicine Past Accepting new patients
Little Angel Silver Star LLC Family Medicine Past Accepting new patients
Bethesda/Solantic Joint Venture, LLC PastSince Jul 2, 2009 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1316943905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4614 S KIRKMAN RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328112891",
            "telephone_number": "407-512-5700",
            "fax_number": "800-752-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4614 S KIRKMAN RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328112891",
            "telephone_number": "407-512-5700",
            "fax_number": "800-752-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERKES",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME44739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "593516436003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "7194953",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAILHANDLERS",
            "identifier": "773114",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "593516436",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "47696",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "695956",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GBA MEDICARE",
            "identifier": "P00397528",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.