Individual provider Active NPI

Kenneth R Snyder, MD

  • Internal Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1528177102
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0070209 Issued in FL
Practice address
11162 Osprey Lake LN
West Palm Beach, FL 33412-1115
Phone
(561) 776-9972
NPI assigned
Aug 29, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 ME0070209 FL Primary

Addresses

Primary practice location

11162 Osprey Lake LN
West Palm Beach, FL 33412-1115

Mailing address

11162 Osprey Lake LN
West Palm Beach, FL 33412-1115
Phone (561) 776-9972

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
I20130507000281 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1153229315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0070209FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth R. Snyder, MD, PA Internal Medicine PastSince Mar 18, 2004 Accepting new patients
Mobile Medical Industries Inc Past Accepting new patients

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, 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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1528177102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11162 OSPREY LAKE LN",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334121115",
            "telephone_number": "561-776-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11162 OSPREY LAKE LN",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334121115",
            "telephone_number": "561-776-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0070209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.