Individual provider Active NPI

Kitonga Peter Kiminyo, MD

  • Infectious Disease Physician
  • Boynton Beach, FL
National Provider Identifier
1649373101
Registry record updated Jan 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME0086064 Issued in FL
Practice address
2300 South Congress Ave Ste 100
Boynton Beach, FL 33426
Phone
(561) 735-7531
Fax
(561) 742-8250
NPI assigned
Sep 7, 2006
Last updated
Jan 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X ME0086064 FL Primary

Addresses

Primary practice location

2300 South Congress Ave Ste 100
Boynton Beach, FL 33426

Mailing address

2300 South Congress Ave Ste 100
Boynton Beach, FL 33426
Phone (561) 735-7531

Other identifiers 3

IdentifierTypeStateIssuer
7779541OtherFLAETNA
78615OtherFLBLUE CROSS
119744400MedicaidFL

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
I20120131000176 FL Practitioner - Infectious DiseasePractitioner - Internal Medicine 8325945322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Howard University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Id Consultants IncGroup PAC ID 5991602963, 5 clinicians

Practice addresses (Care Compare)

10101 Forest Hill Blvd
Wellington, FL 33414-6103
Phone (561) 798-8500

2201 45TH St
West Palm Beach, FL 33407-2047
Phone (561) 842-6141

2300 S Congress Ave
Suite 100
Boynton Beach, FL 33426-7400
Phone (561) 735-4829

3060 Melaleuca LN
Palm Springs, FL 33461-5174
Phone (561) 357-7370

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (561) 965-7300

5555 W Blue Heron Blvd
Riviera Beach, FL 33418-7813
Phone (561) 840-0754

9655 W Boynton Beach Blvd
Boynton Beach, FL 33472-4421
Phone (561) 336-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.52 of 100Reported as group
Quality
81.67
Improvement activities
40
Cost
78.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0086064FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Id Consultants Inc Infectious Disease CurrentSince Aug 1, 2002 Accepting new patients
Kielle Medical Limited Liability Company Infectious Disease CurrentSince May 19, 2020 Accepting new patients
Suzanne Y Succop MD PA Infectious Disease Past Accepting new patients

Locations

2300 S Congress Ave
Ste 100
Boynton Beach, FL 33426
Phone (561) 735-4829

2201 45th St
West Palm Beach, FL 33407
Phone (561) 842-6141

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704499200000",
    "number": "1649373101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SOUTH CONGRESS AVE STE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "561-735-7531",
            "fax_number": "561-742-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SOUTH CONGRESS AVE STE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "561-735-7531",
            "fax_number": "561-742-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMINYO",
        "first_name": "KITONGA",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2024-01-06",
        "certification_date": "2024-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME0086064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7779541",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "78615",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119744400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.