NPIMap

Individual provider Active NPI

John Panos, MD

  • Nephrology Physician
  • Boca Raton, FL
National Provider Identifier
1407887128
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
85030 Issued in FL
Practice address
1905 Clint Moore Rd #212
Boca Raton, FL 33496
Phone
(561) 989-9070
Fax
(561) 989-0255
NPI assigned
Jul 5, 2006
Last updated
Jun 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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 85030 FL Primary

Addresses

Primary practice location

1905 Clint Moore Rd #212
Boca Raton, FL 33496

Mailing address

1905 Clint Moore Rd #212
John Panos MD
Boca Raton, FL 33496
Phone (561) 989-9040

Other identifiers 1

IdentifierTypeStateIssuer
265762700MedicaidFL

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
I20110708000421 FL Practitioner - Nephrology 4385640770 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
State University of New York at Buffalo School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

1905 Clint Moore Rd
Suite 212
Boca Raton, FL 33496-2659
Phone (561) 989-9070

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
70.52
Promoting interoperability
100
Improvement activities
40
Cost
73.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85030FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Mar 24, 2020 Accepting new patients
Infusion Center of Jacksonville, LLC CurrentSince Jul 1, 2019 Accepting new patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Mar 24, 2020 Accepting new patients
MPP Infusion Center of Orlando, LLC CurrentSince Jul 19, 2020 Accepting new patients

Locations

1626 Cole Blvd
Ste 225
Lakewood, CO 80401

1905 Clint Moore Rd
Ste 212
Boca Raton, FL 33496
Phone (561) 208-2121

670 Glades Rd
Ste 110
Boca Raton, FL 33431
Phone (561) 289-9467

2655 W Atlantic Ave
Delray Beach, FL 33445
Phone (561) 279-2626

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

11512 Lake Mead Ave
Ste 302303
Jacksonville, FL 32256
Phone (720) 465-5030

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

1573 W Fairbanks Ave
Ste 200
Winter Park, FL 32789
Phone (407) 637-8300

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • Direct secure messaging: john.panos.1@15644.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1407887128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD #212",
            "address_2": "JOHN PANOS MD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33496",
            "telephone_number": "561-989-9040",
            "fax_number": "561-989-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD #212",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33496",
            "telephone_number": "561-989-9070",
            "fax_number": "561-989-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOS",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "85030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265762700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.