Active NPI
Kenneth Roland Safko, M.D.
- Ophthalmology Physician
- St Petersburg, FL
National Provider Identifier
1336330794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME14133
- Practice address
- 300 Beach Dr NE
Unit 306
St Petersburg, FL 33701-3482 - Phone
- (727) 894-3441
- NPI assigned
- Aug 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | ME14133 | FL | Primary |
Addresses
Primary practice location
300 Beach Dr NE
Unit 306
St Petersburg, FL 33701-3482
Mailing address
300 Beach Dr NE
Unit 306
St Petersburg, FL 33701-3482
Phone (727) 894-3441
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME14133 | FL | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1336330794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 BEACH DR NE",
"address_2": "UNIT 306",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337013482",
"telephone_number": "727-894-3441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 BEACH DR NE",
"address_2": "UNIT 306",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337013482",
"telephone_number": "727-894-3441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAFKO",
"first_name": "KENNETH",
"middle_name": "ROLAND",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-09",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME14133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.