Individual provider Active NPI

Chelsea Kesty, MD

  • Dermatology Physician
  • St Petersburg, FL
National Provider Identifier
1417419342
Registry record updated May 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME161261 Issued in FL
Practice address
100 40TH Ave N
St Petersburg, FL 33703-6125
Phone
(727) 474-9399
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME161261 FL Primary

Addresses

Primary practice location

100 40TH Ave N
St Petersburg, FL 33703-6125

Mailing address

1945 State Route 33
Neptune, NJ 07753-4859

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
I20230602000113 FL Practitioner - Dermatology 9931566106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of South Florida College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Petersburg Skin and Laser Center LLCGroup PAC ID 0840621587, 2 clinicians

Practice addresses (Care Compare)

100 40TH Ave N
St Petersburg, FL 33703-6125
Phone (727) 474-9399

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14
Removal of skin lesions287
Skin biopsy59

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Petersburg Skin and Laser Center LLC Dermatology CurrentSince Jul 1, 2023 Accepting new patients

Locations

100 40th Ave N
St Petersburg, FL 33703
Phone (727) 474-4938

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685318400000",
    "number": "1417419342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 STATE ROUTE 33",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 40TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337036125",
            "telephone_number": "727-474-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTY",
        "first_name": "CHELSEA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-05-29",
        "certification_date": "2023-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME161261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.