Individual provider Active NPI

Kenneth Arthur Neifeld, M.D.

  • Internal Medicine Physician
  • Seminole, FL
National Provider Identifier
1669400586
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME64972 Issued in FL
Practice address
8900 Park Blvd
Seminole, FL 33777-4119
Phone
(727) 545-4545
Fax
(727) 548-1360
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME64972 FL Primary

Addresses

Primary practice location

8900 Park Blvd
Seminole, FL 33777-4119

Mailing address

2191 9TH Avenue North
Suite 110
St Petersburg, FL 33713-7147
Phone (727) 820-7778

Other identifiers 1

IdentifierTypeStateIssuer
373852300MedicaidFL

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
I20090615000176 FL Practitioner - Internal Medicine 7517017437 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME64972FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
All Care Medical Consultants PA CurrentSince Feb 1, 2018 Accepting new patients
All Care Medical Consultants PA Internal Medicine CurrentSince Feb 1, 2018 Accepting new patients
Ante Rudez MD PA Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients

Locations

1745 S Highland Ave
Clearwater, FL 33756
Phone (727) 585-4488

8900 Park Blvd
Seminole, FL 33777
Phone (727) 545-4545

Organizations & group practices 4

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1669400586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 9TH AVENUE NORTH",
            "address_2": "SUITE 110",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337137147",
            "telephone_number": "727-820-7778",
            "fax_number": "727-820-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 PARK BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337774119",
            "telephone_number": "727-545-4545",
            "fax_number": "727-548-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIFELD",
        "first_name": "KENNETH",
        "middle_name": "ARTHUR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME64972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373852300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

Verify at the official NPI Registry.