Individual provider Active NPI

Kamal Hitendra Makati, MD

  • Internal Medicine Physician
  • Holiday, FL
National Provider Identifier
1417586975
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME158020 Issued in FL
Practice address
3346 US Highway 19
Holiday, FL 34691-1846
Phone
(727) 615-6702
NPI assigned
Apr 6, 2020
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME158020 FL Primary

Addresses

Primary practice location

3346 US Highway 19
Holiday, FL 34691-1846

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (615) 315-5257

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
I20240116001630 FL Practitioner - Internal Medicine 8729430764 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME158020FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Medical of Florida, LLC Internal Medicine CurrentSince Dec 11, 2023 Accepting new patients

Locations

3346 US Highway 19
Holiday, FL 34691
Phone (727) 615-6702

543 Tamiami Trl S
Venice, FL 34285
Phone (941) 837-8002

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1417586975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "615-315-5257",
            "fax_number": "615-692-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3346 US HIGHWAY 19",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346911846",
            "telephone_number": "727-615-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKATI",
        "first_name": "KAMAL",
        "middle_name": "HITENDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME158020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holiday, FL

Sources for this page

Verify at the official NPI Registry.