Kenneth Richard Kesty

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

79212 Issued in FL

Practice address

1395 Brightwaters Blvd NE
St Petersburg, FL 33704-3807

Phone

(727) 688-4529

NPI assigned

Feb 2, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580601600000",
    "number": "1598396137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 BRIGHTWATERS BLVD NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337043807",
            "telephone_number": "727-688-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 BRIGHTWATERS BLVD NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337043807",
            "telephone_number": "727-688-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTY",
        "first_name": "KENNETH",
        "middle_name": "RICHARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-02",
        "last_updated": "2020-02-02",
        "certification_date": "2020-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "79212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie B Kessel, MD
• Evanna Monique Kessler
• Marissa Kessler, MS, ED.S
• Chelsea Kesty, MD
• Katarina Rose Kesty, M.D.
• Alexandria Victoria Ketchersid, LCSW
• Carmen Ketchum-Lugo
• Ravi Reddy Kethireddy, MD
• Mara S Kevan, DACM, L.AC., DIPL.AC
• Key Counseling and Supervision

• Ophthalmic Plastic and Reconstructive Surgery Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.