Individual provider Active NPI

Michelle Anne Kirwan, M.D.

  • Pediatrics Physician
  • Plantation, FL
National Provider Identifier
1649308669
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME88448 Issued in FL
Practice address
4100 S Hospital Dr Ste 110
Plantation, FL 33317-2831
Phone
(954) 584-8222
Fax
(954) 584-8224
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME88448 FL Primary

Addresses

Primary practice location

4100 S Hospital Dr Ste 110
Plantation, FL 33317-2831

Mailing address

19380 Collins Ave Apt 1212
Sunny Isles Beach, FL 33160-2237

Other identifiers 1

IdentifierTypeStateIssuer
267657500MedicaidFL

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
I20050314000358 FL Practitioner - Pediatric Medicine 4385699347 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME88448FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family and Child Enrichment, Inc CurrentSince Mar 18, 2024 Accepting new patients
Collier Health Services Inc Past Accepting new patients
Dorothy V Straw Pediatrics Past Accepting new patients

Locations

1825 NW 167th St
#108109
Miami Gardens, FL 33056
Phone 30562474501842

1825 NW 167th St
#108
Miami Gardens, FL 33056
Phone 30562474501794

Interoperability endpoints

  • Direct secure messaging: mkirwan@cfcecares.directbygreenway.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Center for Family and Child Enrichment IncMiami Gardens, FL, CCN 101153 Federally qualified health center W-2 Managing Employee Apr 10, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1649308669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19380 COLLINS AVE APT 1212",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331602237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S HOSPITAL DR STE 110",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172831",
            "telephone_number": "954-584-8222",
            "fax_number": "954-584-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRWAN",
        "first_name": "MICHELLE",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME88448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267657500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.