Individual provider Active NPI

Kenneth Alan Rappaport, D.O.

  • Nephrology Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1447210372
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME0043853 Issued in FL
Practice address
3401 Pga Blvd Ste 310
Palm Beach Gardens, FL 33410-2824
Phone
(561) 296-8042
Fax
(561) 766-2159
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME43853 FL
Nephrology Physician 207RN0300X ME0043853 FL Primary

Addresses

Primary practice location

3401 Pga Blvd Ste 310
Palm Beach Gardens, FL 33410-2824

Mailing address

3401 Pga Blvd Ste 310
Palm Beach Gardens, FL 33410-2824
Phone (561) 296-8042

Other identifiers 1

IdentifierTypeStateIssuer
035109100MedicaidFL

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
I20100809001110 FL Practitioner - NephrologyPractitioner - Internal Medicine 4385696327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caremedica Florida LLCGroup PAC ID 2365826849, 6 clinicians

Practice addresses (Care Compare)

3401 Pga Blvd
Suite 310
Palm Beach Gardens, FL 33410-2824
Phone (561) 776-8890

Hospital & facility affiliations

  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253
  • Palm Beach Gardens Medical Center Hospital, Palm Beach Gardens, FL, CCN 100176

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0043853FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caremedica Florida LLC Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
Nelson Lopez MD PA PastSince Jul 9, 2018 Accepting new patients

Locations

3401 Pga Blvd
Ste 310
Palm Beach Gardens, FL 33410
Phone (561) 776-8890

Interoperability endpoints

  • Direct secure messaging: krappaport20672@jupitermedicalcenter.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHJJBA

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1447210372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 PGA BLVD STE 310",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102824",
            "telephone_number": "561-296-8042",
            "fax_number": "561-766-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 PGA BLVD STE 310",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102824",
            "telephone_number": "561-296-8042",
            "fax_number": "561-766-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPPAPORT",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME43853",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME0043853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035109100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.