Individual provider Active NPI

Kathleen Fraga, MD

  • Emergency Medicine Physician
  • Vero Beach, FL
National Provider Identifier
1346411121
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME118659 Issued in FL
Practice address
1960 Pointe West Dr
Vero Beach, FL 32966-1302
Phone
(772) 226-4250
Fax
(772) 226-4253
NPI assigned
Mar 19, 2008
Last updated
Feb 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME118659 FL Primary
Emergency Medicine Physician 207P00000X MD437917 PA

Addresses

Primary practice location

1960 Pointe West Dr
Vero Beach, FL 32966-1302

Mailing address

1960 Pointe West Dr
Vero Beach, FL 32966-1302
Phone (772) 226-4250

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
I20150406000788 FL Practitioner - Emergency Medicine 2163740093 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD437917PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Apr 1, 2015 Accepting new patients
Indian River Health Services Inc CurrentSince Apr 1, 2015 Accepting new patients
Indian River Health Services Inc Past Accepting new patients

Locations

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1346411121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 POINTE WEST DR",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329661302",
            "telephone_number": "772-226-4250",
            "fax_number": "772-226-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 POINTE WEST DR",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329661302",
            "telephone_number": "772-226-4250",
            "fax_number": "772-226-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGA",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME118659",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD437917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.