Individual provider Active NPI

Kenneth Calder, M.D.

  • Dermatopathology (Pathology) Physician
  • Tampa, FL
National Provider Identifier
1639361447
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
ME108309 Issued in FL
Practice address
10500 University Center Dr
Suite 200
Tampa, FL 33612-6494
Phone
(800) 929-6694
Fax
(813) 971-6675
NPI assigned
Aug 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN8901 FL
Dermatopathology (Pathology) Physician 207ZD0900X ME108309 FL Primary

Addresses

Primary practice location

10500 University Center Dr
Suite 200
Tampa, FL 33612-6494

Mailing address

14275 Midway Rd
Ste 400
Addison, TX 75001-3676
Phone (800) 330-6565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161010001891 FL Order and Referring Only - PathologyPractitioner - Pathology 2668760505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME108309FLMDDermatopathology (Pathology) Physician
TRN8901FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ameripath Florida LLC Past Accepting new patients
Ameripath Florida LLC PastSince Nov 5, 2023 Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1639361447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD",
            "address_2": "STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013676",
            "telephone_number": "800-330-6565",
            "fax_number": "561-712-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 UNIVERSITY CENTER DR",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336126494",
            "telephone_number": "800-929-6694",
            "fax_number": "813-971-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDER",
        "first_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN8901",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "FL",
            "license": "ME108309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.