Individual provider Active NPI

Kenneth Shapiro

  • Foot Surgery Podiatrist
  • Clearwater, FL
National Provider Identifier
1639654148
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
PO3126 Issued in FL
Practice address
6021 142ND Ave N
Clearwater, FL 33760-2822
Phone
(727) 796-6900
NPI assigned
Oct 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X PO3126 FL Primary

Addresses

Primary practice location

6021 142ND Ave N
Clearwater, FL 33760-2822

Mailing address

7209 Promenade Dr Apt 601
Boca Raton, FL 33433-2809
Phone (561) 271-9497

Other practice location 1

7209 Promenade Dr Apt 601
Boca Raton, FL 33433-2809
Phone (561) 271-9497

Other identifiers 1

IdentifierTypeStateIssuer
101996200MedicaidFL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190208001714 FL Practitioner - Podiatry 7315285871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
KG Health Partners IncGroup PAC ID 7214820976, 19 clinicians

Practice addresses (Care Compare)

6021 142ND Ave N
Clearwater, FL 33760-2822
Phone (727) 796-6900

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue2237
Removal or shaving of skin growth274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KG Health Partners, Inc Single Specialty CurrentSince Feb 4, 2019 Accepting new patients
Community Health Solutions of America, Inc. CurrentSince Oct 21, 2025 Accepting new patients

Locations

6021 142nd Ave N
Clearwater, FL 33760
Phone (727) 431-4850

13600 Icot Blvd
Clearwater, FL 33760
Phone (727) 796-6900

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1639654148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7209 PROMENADE DR APT 601",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334332809",
            "telephone_number": "561-271-9497",
            "fax_number": "888-857-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 142ND AVE N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337602822",
            "telephone_number": "727-796-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7209 Promenade Dr Apt 601",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334332809",
            "country_code": "US",
            "telephone_number": "561-271-9497",
            "fax_number": "888-857-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "KENNETH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-01",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO3126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101996200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.