Individual provider Active NPI

Paul J Kalin, D.P.M.

  • Foot Surgery Podiatrist
  • Fort Walton Beach, FL
National Provider Identifier
1336177401
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
POOOO1692 Issued in FL
Practice address
1013 Mar Walt Dr
Suite a
Fort Walton Beach, FL 32547-6723
Phone
(850) 863-1238
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X POOOO1692 FL Primary

Addresses

Primary practice location

1013 Mar Walt Dr
Suite a
Fort Walton Beach, FL 32547-6723

Mailing address

1013 Mar Walt Dr
Suite a
Fort Walton Beach, FL 32547-6723
Phone (850) 863-1238

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110316000807 FL Practitioner - Podiatry 4981886629 Practice locations: Ft Walton Beach, FL; Niceville, FL

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1013 Mar Walt Dr
Suite a
Fort Walton Beach, FL 32547-6706

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue305
Removal or shaving of skin growth112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POOOO1692FLMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul J Kalin PastSince Dec 23, 1987 Accepting new patients
Anesthesia Management, Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1336177401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 MAR WALT DR",
            "address_2": "SUITE A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476723",
            "telephone_number": "850-863-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 MAR WALT DR",
            "address_2": "SUITE A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476723",
            "telephone_number": "850-863-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIN",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "POOOO1692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.