Individual provider Active NPI

Kinjal K Talati, NP

  • Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1669978383
Registry record updated Nov 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704294266 Issued in MI
Practice address
2725 Park Dr Ste 5
Clearwater, FL 33763-1023
Phone
(727) 733-3500
NPI assigned
Apr 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11001768 FL
Nurse Practitioner 363L00000X 4704294266 MI Primary

Addresses

Primary practice location

2725 Park Dr Ste 5
Clearwater, FL 33763-1023

Mailing address

2577 Hidden Cove LN
Clearwater, FL 33763-2168
Phone (734) 679-4306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180524002032 MI Practitioner - Nurse Practitioner 6002171931 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11001768FLMDNurse Practitioner
4704294266MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Infectious Disease Associates, PC CurrentSince Apr 18, 2018 Accepting new patients
Vidya Sagar MD PA CurrentSince Nov 21, 2021 Accepting new patients

Locations

2725 Park Dr
Ste 5
Clearwater, FL 33763
Phone (727) 733-3500

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

13430 E 13 Mile Rd
Warren, MI 48088
Phone (248) 854-8999

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Organizations & group practices 2

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636761600000",
    "number": "1669978383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 HIDDEN COVE LN",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337632168",
            "telephone_number": "734-679-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 PARK DR STE 5",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631023",
            "telephone_number": "727-733-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALATI",
        "first_name": "KINJAL",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2021-11-13",
        "certification_date": "2021-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11001768",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704294266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.