Individual provider Active NPI

Kathryn Zeoli, M.D.

  • Specialist
  • Pembroke Pines, FL
National Provider Identifier
1588674253
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0036826 Issued in FL
Practice address
10001 Pines Blvd
Pembroke Pines, FL 33024-6136
Phone
(954) 436-5625
Fax
(954) 678-3989
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0036826 FL Primary

Addresses

Primary practice location

10001 Pines Blvd
Pembroke Pines, FL 33024-6136

Mailing address

10001 Pines Blvd
Pembroke Pines, FL 33024-6136
Phone (954) 436-5625

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
I20110221000297 FL Practitioner - Dermatology 9931158193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Miami, LM Miller School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Cancer Treatment CenterGroup PAC ID 2961451125, 6 clinicians

Practice addresses (Care Compare)

10001 Pines Blvd
Pembroke Pines, FL 33024-6136
Phone (954) 436-5625

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision118
Removal of skin lesions236
Removal of skin cancer1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0036826FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Cancer Treatment Center Specialist CurrentSince Apr 30, 1999 Accepting new patients

Locations

2001 E Commercial Blvd
Ft Lauderdale, FL 33308
Phone (954) 436-5625

10001 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 436-5625

10067 Pines Blvd
#A
Pembroke Pines, FL 33024
Phone (954) 430-6900

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1588674253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246136",
            "telephone_number": "954-436-5625",
            "fax_number": "954-436-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246136",
            "telephone_number": "954-436-5625",
            "fax_number": "954-678-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEOLI",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0036826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.