Individual provider Active NPI

Rene Chalom, M.D.

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1407816481
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
188193 Issued in NY
Practice address
6535 Nemours Pkwy
Orlando, FL 32827-7884
Phone
(407) 567-4000
Fax
(407) 567-5924
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X MTL-2018-011 GU
Pediatric Critical Care Medicine Physician 2080P0203X 25MA05756000 NJ
Pediatric Critical Care Medicine Physician 2080P0203X ME120876 FL
Pediatrics Physician 208000000X 188193 NY Primary
Pediatrics Physician 208000000X M13113 ID
Pediatrics Physician 208000000X 25MA05756000 NJ
Pediatrics Physician 208000000X C1-0011572 DE

Addresses

Primary practice location

6535 Nemours Pkwy
Orlando, FL 32827-7884

Mailing address

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532
Phone (904) 697-4100

Other practice location 1

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-5930

Other identifiers 1

IdentifierTypeStateIssuer
014372000MedicaidFL

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address rec9098@direct.nyp.org Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA, NY, FL, MA, WY, CA, DE8 enrollments
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 8

Enrollment IDStateProvider typePAC IDDetails
I20040710000011 NJ Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 6800874413 Reassigns benefits to 5 organizations
I20091222000124 PA Practitioner - Pediatric Medicine 6800874413 Reassigns benefits to 2 organizations
I20100415000265 NY Practitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 6800874413 Reassigns benefits to 2 organizations
I20150318001938 FL Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 6800874413 Reassigns benefits to 3 organizations
I20150910000881 MA Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 6800874413 Reassigns benefits to 2 organizations
I20240320002139 WY Practitioner - Pediatric MedicinePractitioner - Other (Physician)Practitioner - Critical Care (Intensivists) 6800874413 Reassigns benefits to 1 organization
I20241018002925 CA Practitioner - Pediatric Medicine 6800874413 Reassigns benefits to 2 organizations
I20250417002376 DE Practitioner - Pediatric Medicine 6800874413 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Cooper Pediatrics Pediatrics CurrentSince Aug 17, 2014 Accepting new patients
Banner Hospital Based Physicians West LLC CurrentSince Mar 23, 2024 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince May 17, 2014 Accepting new patients
The Nemours Foundation Current Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
Banner Hospital Based Physicians West LLC CurrentSince Mar 23, 2024 Accepting new patients
Lawrence Medical Associates, PC Current Accepting new patients
Montefiore New Rochelle Hospital CurrentSince Mar 18, 2021 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
Lawrence Medical Associates, PC CurrentSince Oct 17, 2024 Accepting new patients
The Nemours Foundation CurrentSince Feb 19, 2015 Accepting new patients
Physicians of Cape Cod Hospital CurrentSince Aug 12, 2015 Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Mar 22, 2020 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Pratt Pediatric Associates Inc Pediatrics CurrentSince Aug 30, 2022 Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2019 Accepting new patients
STC Pediatrics LLC Pediatrics Current Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2019 Accepting new patients
Cooper Pediatric Specialists, PC Pediatrics CurrentSince Aug 17, 2014 Accepting new patients
Lawrence Medical Associates, PC CurrentSince Oct 17, 2024 Accepting new patients
Banner Health CurrentSince Jul 21, 2025 Accepting new patients
Nemours New Jersey Physician Practice, P.C. Pediatrics CurrentSince Feb 4, 2024 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Apr 1, 2025 Accepting new patients
The Nemours Foundation CurrentSince Feb 19, 2015 Accepting new patients
Paragon Emergency Services LLC Pediatrics CurrentSince Jan 1, 2016 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Sep 1, 2024 Accepting new patients
Sutter Valley Medical Foundation Pediatrics Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Sep 1, 2024 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Apr 1, 2025 Accepting new patients
Banner Health CurrentSince Jul 21, 2025 Accepting new patients
Hospital Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince May 17, 2014 Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Mar 22, 2020 Accepting new patients
Amboy Medical Practice PC Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Wyoming Medical Center Inc Past Accepting new patients
Pediatric Critical Care Associates at Saint Barnabas Pediatric Critical Care Medicine Past Accepting new patients
Amboy Medical Practice PC Pediatrics PastSince Sep 1, 2024 Accepting new patients

Locations (25 of 40)

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

1680 Bunyan Rd
Susanville, CA 96130
Phone (530) 252-2235

640 S State St
Dover, DE 19901
Phone (302) 744-4700

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

1717 S Orange Ave
Ste 100
Orlando, FL 32806

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

1 Cooper Plz
Fl 7
Camden, NJ 08103
Phone (856) 342-2265

3 Cooper Plz
Rm 520
Camden, NJ 08103
Phone (856) 342-2298

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: rchalom52321@direct.nemours.org
  • Direct secure messaging: rchalom86044@tuftsmedicine.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/dcf3b1c6-3971-4673-962e-8b2cce0ff827/
  • Direct secure messaging: rchalom697610@hisp.ehr.sutterhealth.org

Organizations & group practices 39

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.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1407816481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-4100",
            "fax_number": "904-697-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 NEMOURS PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277884",
            "telephone_number": "407-567-4000",
            "fax_number": "407-567-5924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 Kootenai Health Way",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838146051",
            "country_code": "US",
            "telephone_number": "208-625-5930",
            "fax_number": "208-625-5931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHALOM",
        "first_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "GU",
            "license": "MTL-2018-011",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA05756000",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME120876",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "188193",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "M13113",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05756000",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C1-0011572",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014372000",
            "state": "FL"
        }
    ],
    "endpoints": [
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            "endpointTypeDescription": "FHIR URL",
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            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "55 Palmer Ave",
            "city": "Bronxville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107083403",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rec9098@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "55 Palmer Ave",
            "city": "Bronxville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107083403",
            "country_name": "United States",
            "address_type": "DOM"
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        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "55 Palmer Ave",
            "city": "Bronxville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107083403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.