NPIMap

Individual provider Active NPI

Kevin D Deboer, D.O.

  • Pulmonary Disease Physician
  • Orlando, FL
National Provider Identifier
1649272402
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
OS10699 Issued in FL
Practice address
1115 E. Ridgewood Street
Orlando, FL 32803
Phone
(407) 841-1100
Fax
(407) 841-0774
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS10699 FL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 334080 NY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X OS10699 FL
Pulmonary Disease Physician 207RP1001X 334080 NY
Pulmonary Disease Physician 207RP1001X OS10699 FL Primary

Addresses

Primary practice location

1115 E. Ridgewood Street
Orlando, FL 32803

Mailing address

326 N Mills Ave
Orlando, FL 32803-5734
Phone (407) 841-1100

Other practice location 1

133 Park St
Malone, NY 12953-1244
Phone (518) 483-3000

Other practice location 2

206 Cornelia St
Plattsburgh, NY 12901-2878
Phone (518) 562-7705

Other identifiers 1

IdentifierTypeStateIssuer
001667000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kevin.deboer.p1@direct.cfpg.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091221000552 FL Practitioner - Pulmonary Disease 4082602636 Reassigns benefits to 2 organizations
I20250519003233 NY Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 4082602636 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Rowan University School of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Florida Pulmonary Group PAGroup PAC ID 8729983523, 16 clinicians

Practice addresses (Care Compare)

1115 E Ridgewood St
Orlando, FL 32803-5443

206 Cornelia St
Suite 102
Plattsburgh, NY 12901-2779
Phone (518) 562-7544

610 Jasmine Rd
Altamonte Springs, FL 32701-4817
Phone (407) 385-1332

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
334080NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Internal Medicine CurrentSince May 14, 2025 Accepting new patients
Elizabethtown Community Hospital CurrentSince May 14, 2025 Accepting new patients
Champlain Valley Physicians Hospital Medical Center Internal Medicine CurrentSince May 14, 2025 Accepting new patients
Alice Hyde Medical Center Current Accepting new patients
Elizabethtown Community Hospital CurrentSince May 14, 2025 Accepting new patients
Sleep Ez Past Accepting new patients
Carlos a Obregon, D.O.,P.C. Critical Care Medicine Past Accepting new patients
Northern Lights Sleep Medicine, PC Past Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

206 Cornelia St
Plattsburgh, NY 12901
Phone (518) 561-5516

206 Cornelia St
Ste 102
Plattsburgh, NY 12901
Phone (518) 314-3344

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kdeboer624209@direct.uvmhealth.org
  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886

Organizations & group practices 11

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 8

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1649272402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035734",
            "telephone_number": "407-841-1100",
            "fax_number": "407-649-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E. RIDGEWOOD STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32803",
            "telephone_number": "407-841-1100",
            "fax_number": "407-841-0774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Park St",
            "address_purpose": "LOCATION",
            "city": "Malone",
            "state": "NY",
            "postal_code": "129531244",
            "country_code": "US",
            "telephone_number": "518-483-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 Cornelia St",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129012878",
            "country_code": "US",
            "telephone_number": "518-562-7705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "KEVIN",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS10699",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "334080",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "OS10699",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "334080",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "OS10699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001667000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevin.deboer.p1@direct.cfpg.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1115 E. Ridgewood Street",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.