Individual provider Active NPI

James Michael Kemmerling, MD

  • Surgery Physician
  • Wimauma, FL
National Provider Identifier
1376656165
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME141776 Issued in FL
Practice address
16553 S US Highway 301
Wimauma, FL 33598-2032
Phone
(800) 991-6117
Fax
(888) 812-8191
NPI assigned
Aug 16, 2006
Last updated
Apr 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35428 WI
Surgery Physician 208600000X ME141776 FL Primary

Addresses

Primary practice location

16553 S US Highway 301
Wimauma, FL 33598-2032

Mailing address

3810 Northdale Blvd Ste 150
Tampa, FL 33624-1871
Phone (813) 961-1331

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
I20190910003824 FL Practitioner - General Surgery 7214833565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wazni PLLCGroup PAC ID 2860629466, 30 clinicians

Practice addresses (Care Compare)

18167 US Hwy 19 N
Suite 100
Clearwater, FL 33764-6565
Phone (727) 233-4177

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal243

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME141776FLMDSurgery Physician
35428WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wazni, PLLC Surgery CurrentSince Sep 1, 2019 Accepting new patients
Colorado Medical Group, PLLC Surgery PastSince Sep 1, 2019 Accepting new patients

Locations

1900 Glades Rd
Ste 100
Boca Raton, FL 33431
Phone (561) 416-1145

18167 US Highway 19 N
Ste 100
Clearwater, FL 33764
Phone (727) 233-4177

2290 10th Ave N
Ste 101
Lake Worth, FL 33461
Phone (561) 450-2703

3003 S Florida Ave
Ste 101
Lakeland, FL 33803
Phone (863) 687-8990

4619 Little Rd
New Pt Richey, FL 34655
Phone (727) 372-9918

4215 Burns Rd
Ste 260
Palm Beach Gardens, FL 33410

295 NW Peacock Blvd
Port St Lucie, FL 34986

3609 Madaca Ln
Tampa, FL 33618
Phone (720) 253-3071

3657 Madaca Ln
Tampa, FL 33618

3810 Northdale Blvd
Ste 150
Tampa, FL 33624
Phone (813) 683-4784

3810 Northdale Blvd
Ste 260
Tampa, FL 33624

3820 Northdale Blvd
Ste 201
Tampa, FL 33624

8029 Cooper Creek Blvd
Ste 104
University Park, FL 34201

16553 S US Highway 301
Wimauma, FL 33598

Interoperability endpoints

  • Direct secure messaging: james.kemmerling@uvvc.eclinicaldirectplus.com

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, 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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1376656165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 NORTHDALE BLVD STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241871",
            "telephone_number": "813-961-1331",
            "fax_number": "888-850-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16553 S US HIGHWAY 301",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335982032",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMMERLING",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "35428",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME141776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wimauma, FL

Sources for this page

Verify at the official NPI Registry.