Individual provider Active NPI

Kym A Pallatto, PA

  • Surgical Physician Assistant
  • Stuart, FL
National Provider Identifier
1629022322
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9106272 Issued in FL
Practice address
1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Phone
(772) 288-2400
Fax
(772) 419-0549
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9106272 FL Primary

Addresses

Primary practice location

1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512

Mailing address

1050 SE Monterey Rd
Suite 400
Stuart, FL 34994-4512
Phone (772) 288-2400

Other practice location 1

9401 SW Discovery Way
Port St Lucie, FL 34987-2376
Phone (772) 288-2400

Other identifiers 2

IdentifierTypeStateIssuer
290001280CT01OtherCTBC
128000OtherCTCONNECTICARE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120601000531 FL Practitioner - Physician Assistant 2769670694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001280CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince Feb 21, 2012 Accepting new patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince Feb 21, 2012 Accepting new patients
South Florida Orthopaedics & Sports Medicine,PA Past Accepting new patients

Locations

9401 SW Discovery Way
Ste 201
Port St Lucie, FL 34987

9401 SW Discovery Way
Port St Lucie, FL 34987

1050 SE Monterey Rd
Ste 204
Stuart, FL 34994
Phone (772) 781-5960

1050 SE Monterey Rd
Ste 400
Stuart, FL 34994

Interoperability endpoints

  • Direct secure messaging: kym.pallattopac.p1@direct.southflaortho.nextgenshare.com

Organizations & group practices 3

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1629022322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD",
            "address_2": "SUITE 400",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-288-2400",
            "fax_number": "772-419-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD STE 400",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-288-2400",
            "fax_number": "772-419-0549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9401 SW Discovery Way",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349872376",
            "country_code": "US",
            "telephone_number": "772-288-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALLATTO",
        "first_name": "KYM",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9106272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "290001280CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "128000",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.