Active NPI
Judith Ann Kaltenbach, PA-C
- Internal Medicine Physician
- Longwood, FL
National Provider Identifier
1356498307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- PA3205
- Practice address
- 1200 W Sr 434 Ste 112
Longwood, FL 32750-4957 - Phone
- (407) 869-8747
- Fax
- (407) 869-8108
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | PA3205 | FL | Primary |
Addresses
Primary practice location
1200 W Sr 434 Ste 112
Longwood, FL 32750-4957
Mailing address
1200 W Sr 434 Ste 112
Longwood, FL 32750-4957
Phone (407) 869-8747
Other practice location 1
280 Wekiva Springs Rd
Suite 1000
Longwood, FL 32779-5946
Phone (407) 788-2273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA 3205 | Other | FL | LICENSE PHYSICIAN ASSISTA |
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
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seminole Primary Care Physicians PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Longwood, FL
- NPI 1386785202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652659200000",
"number": "1356498307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 W SR 434 STE 112",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327504957",
"telephone_number": "407-869-8747",
"fax_number": "407-869-8108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W SR 434 STE 112",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327504957",
"telephone_number": "407-869-8747",
"fax_number": "407-869-8108"
}
],
"practiceLocations": [
{
"address_1": "280 Wekiva Springs Rd",
"address_2": "Suite 1000",
"address_purpose": "LOCATION",
"city": "Longwood",
"state": "FL",
"postal_code": "327795946",
"country_code": "US",
"telephone_number": "407-788-2273",
"fax_number": "407-389-2273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KALTENBACH",
"first_name": "JUDITH",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2022-05-16",
"certification_date": "2022-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "PA3205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE PHYSICIAN ASSISTA",
"identifier": "PA 3205",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longwood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.