Individual provider Active NPI

Richard E Kardon, DO

  • Pediatric Cardiology Physician
  • Miami, FL
National Provider Identifier
1396795258
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
OS 10209 Issued in FL
Practice address
1611 NW 12TH Ave
Um Miller School of Medicine, JMH North Wing 109 (R-76)
Miami, FL 33136-1005
Phone
(305) 585-6683
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X OS010552L PA
Pediatric Cardiology Physician 2080P0202X MB 70340 NJ
Pediatric Cardiology Physician 2080P0202X OS 10209 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Um Miller School of Medicine, JMH North Wing 109 (R-76)
Miami, FL 33136-1005

Mailing address

1611 NW 12TH Ave
Um Miller School of Medicine, JMH North Wing 109 (R-76)
Miami, FL 33136-1005
Phone (305) 585-6683

Other identifiers 1

IdentifierTypeStateIssuer
0017742860005MedicaidPA

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
I20080207000285 FL Practitioner - Pediatric Medicine 2769565217 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 10209FLMDPediatric Cardiology Physician
MB 70340NJMDPediatric Cardiology Physician
OS010552LPAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
SCHC Pediatric Associates, LLC Pediatric Cardiology Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1475 NW 12th Ave
#C130
Miami, FL 33136
Phone (305) 243-6857

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1396795258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "UM MILLER SCHOOL OF MEDICINE, JMH NORTH WING 109 (R-76)",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "UM MILLER SCHOOL OF MEDICINE, JMH NORTH WING 109 (R-76)",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDON",
        "first_name": "RICHARD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "PA",
            "license": "OS010552L",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NJ",
            "license": "MB 70340",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "OS 10209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017742860005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.