Individual provider Active NPI

Edu Anthony Kirindongo, MD

  • Family Medicine Physician
  • Lake Park, FL
National Provider Identifier
1629030747
Registry record updated Mar 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME67264 Issued in FL
Practice address
415 US Highway 1 Ste D
Lake Park, FL 33403-3585
Phone
(561) 842-5900
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME67264 FL Primary

Addresses

Primary practice location

415 US Highway 1 Ste D
Lake Park, FL 33403-3585

Mailing address

415 US Highway 1 Ste D
Lake Park, FL 33403-3585
Phone (561) 842-5900

Other identifiers 1

IdentifierTypeStateIssuer
377790100MedicaidFL

Other names 1

  • Dr. Edu Anthony Kirindongo Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edu.kirindongo.1@29601.direct.athenahealth.com

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
I20130430000146 FL Practitioner - Family Practice 1355358516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

415 US Hwy 1
Suite D
Lake Park, FL 33403-3585
Phone (561) 842-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles (5 of 7)

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC Family Medicine CurrentSince Mar 17, 2025 Accepting new patients
Palm Beach Medical Clinic LLC Past Accepting new patients
Anthony Kirindongo MD Corp Family Medicine PastSince Jan 1, 2001 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients
Eena Comprehensive Neurology and Sleep Center Inc PastSince Oct 1, 2024 Accepting new patients

Locations

440 W 49th St
Hialeah, FL 33012
Phone (305) 828-5000

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

415 US Highway 1
Ste D
West Palm Beach, FL 33403
Phone (561) 842-5900

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: edu.kirindongo.1@29601.direct.athenahealth.com

Organizations & group practices 5

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773446400000",
    "number": "1629030747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 US HIGHWAY 1 STE D",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334033585",
            "telephone_number": "561-842-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 US HIGHWAY 1 STE D",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334033585",
            "telephone_number": "561-842-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRINDONGO",
        "first_name": "EDU ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME67264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377790100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edu.kirindongo.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "415 US Highway 1 Ste D",
            "city": "Lake Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334033585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EDU",
            "last_name": "KIRINDONGO",
            "middle_name": "ANTHONY",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lake Park, FL

Sources for this page

Verify at the official NPI Registry.