NPIMap

Individual provider Active NPI

Robert Gerald Kincaid III, D.O.

  • Family Medicine Physician
  • Pace, FL
National Provider Identifier
1386650406
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS 10119 Issued in FL
Practice address
3754 Highway 90
Suite 200
Pace, FL 32571-1096
Phone
(850) 416-5200
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2006018040 MO
Family Medicine Physician 207Q00000X OS 10119 FL Primary

Addresses

Primary practice location

3754 Highway 90
Suite 200
Pace, FL 32571-1096

Mailing address

3754 Highway 90
Suite 200
Pace, FL 32571-1096
Phone (850) 416-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081010000556 FL Practitioner - Family Practice 7618079195 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

3754 Hwy 90
Suite 300
Pace, FL 32571-1098
Phone (850) 416-5510

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions30
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 10119FLMDFamily Medicine Physician
2006018040MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Jul 15, 2008 Accepting new patients
Sacred Heart Health System Inc CurrentSince Jul 15, 2008 Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Jul 15, 2008 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
Tri Hospital MRI Center Past Accepting new patients

Locations

3754 Highway 90
Ste 200
Pace, FL 32571
Phone (850) 416-5200

3754 Highway 90
Ste 300
Pace, FL 32571
Phone (850) 416-5510

6665 Pensacola Blvd
Pensacola, FL 32505
Phone (850) 416-2000

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

Interoperability endpoints

  • Direct secure messaging: robert.kincaid.1@9582.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218153600000",
    "number": "1386650406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3754 HIGHWAY 90",
            "address_2": "SUITE 200",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325711096",
            "telephone_number": "850-416-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3754 HIGHWAY 90",
            "address_2": "SUITE 200",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325711096",
            "telephone_number": "850-416-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "ROBERT",
        "middle_name": "GERALD",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2006018040",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 10119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pace, FL

Sources for this page

Verify at the official NPI Registry.