NPIMap

Individual provider Active NPI

Kenneth Joseph Tourgeman, MD

  • Nephrology Physician
  • Lauderdale Lakes, FL
National Provider Identifier
1396732673
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME91281 Issued in FL
Practice address
2951 NW 49TH Ave
Suite # 301
Lauderdale Lakes, FL 33313-1600
Phone
(954) 739-2221
Fax
(954) 739-2271
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME91281 FL Primary

Addresses

Primary practice location

2951 NW 49TH Ave
Suite # 301
Lauderdale Lakes, FL 33313-1600

Mailing address

2951 NW 49TH Ave
Suite #301
Lauderdale Lakes, FL 33313-1600
Phone (954) 739-2221

Other identifiers 3

IdentifierTypeStateIssuer
1046355OtherFLCAREPLUS
48977OtherFLB C B S
48977ZOtherFLMEDICARE ID

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
I20040914000901 FL Practitioner - NephrologyPractitioner - Internal Medicine 6901873413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2951 NW 49TH Ave
Suite 301
Lauderdale Lakes, FL 33313-1617
Phone (954) 739-2221

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME91281FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Broward Kidney, PA CurrentSince Sep 13, 2020 Accepting new patients

Locations

2951 NW 49th Ave
Ste 301
Lauderdale Lakes, FL 33313
Phone (954) 731-9100

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.

Hospital & facility affiliations 7

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1396732673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 NW 49TH AVE",
            "address_2": "SUITE #301",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333131600",
            "telephone_number": "954-739-2221",
            "fax_number": "954-739-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 NW 49TH AVE",
            "address_2": "SUITE # 301",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333131600",
            "telephone_number": "954-739-2221",
            "fax_number": "954-739-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOURGEMAN",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME91281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREPLUS",
            "identifier": "1046355",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B C B S",
            "identifier": "48977",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "48977Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.