Individual provider Active NPI

Kenneth Appah Sampong, P.A.

  • Cardiovascular Disease Physician
  • Leesburg, FL
National Provider Identifier
1649236167
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME75310 Issued in FL
Practice address
709 Physician CT
Leesburg, FL 34748-7357
Phone
(352) 728-5116
Fax
(352) 728-5928
NPI assigned
Apr 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME75310 FL Primary

Addresses

Primary practice location

709 Physician CT
Leesburg, FL 34748-7357

Mailing address

709 Physician CT
Leesburg, FL 34748-7357
Phone (352) 728-5116

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
I20040304000891 FL Practitioner - Cardiovascular Disease (Cardiology) 0840188652 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

709 Physicians CT
Leesburg, FL 34748-7357
Phone (352) 728-5116

Hospital & facility affiliations

  • Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084
  • Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth Appah Sampong, P.a. Cardiovascular Disease CurrentSince Jun 1, 2005 Accepting new patients
Eze D. Uche, M.D., PA Cardiovascular Disease Past Accepting new patients

Locations

120 E North Blvd
Leesburg, FL 34748
Phone (352) 728-2999

709 Physicians Ct
Leesburg, FL 34748
Phone (352) 728-2999

1050 Old Camp Rd
Ste 270
The Villages, FL 32162
Phone (352) 552-4648

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ksampong563891@direct.shands.ufl.edu
  • Direct secure messaging: kenneth.sampong@ksampong.directbygreenway.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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1649236167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 PHYSICIAN CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487357",
            "telephone_number": "352-728-5116",
            "fax_number": "352-728-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 PHYSICIAN CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487357",
            "telephone_number": "352-728-5116",
            "fax_number": "352-728-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPONG",
        "first_name": "KENNETH",
        "middle_name": "APPAH",
        "name_prefix": "Dr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME75310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.