Individual provider Active NPI

Nilza Kallos, MD

  • Diagnostic Radiology Physician
  • Miami, FL
National Provider Identifier
1659451227
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
24066 Issued in FL
Practice address
5555 Ponce de Leon Blvd
Miami, FL 33143-4721
Phone
(305) 689-0695
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 24066 FL Primary
Diagnostic Radiology Physician 2085R0202X ME24066 FL
Diagnostic Ultrasound Physician 2085U0001X 24066 FL

Addresses

Primary practice location

5555 Ponce de Leon Blvd
Miami, FL 33143-4721

Mailing address

5555 Ponce de Leon Blvd
Miami, FL 33143-4721
Phone (305) 689-0695

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
I20040428001632 FL Practitioner - Diagnostic Radiology 8426045683 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24066FLMDDiagnostic Radiology Physician
ME24066FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
Nilza Kallos, M.D., P.a. Diagnostic Radiology PastSince Jun 1, 2002 Accepting new patients

Locations

5555 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 585-1052

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

Interoperability endpoints

  • Direct secure messaging: nkallos45786@direct.med.miami.edu

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1659451227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PONCE DE LEON BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331434721",
            "telephone_number": "305-689-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PONCE DE LEON BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331434721",
            "telephone_number": "305-689-0695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLOS",
        "first_name": "NILZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "24066",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME24066",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "FL",
            "license": "24066",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.