Individual provider Active NPI

Charles N Ekinde, MD

  • Hospitalist Physician
  • Miami, FL
National Provider Identifier
1679567580
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME87673 Issued in FL
Practice address
9555 SW 162ND Ave
Miami, FL 33196-6408
Phone
(786) 467-2159
Fax
(786) 533-9703
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 059633 GA
Hospitalist Physician 208M00000X ME87673 FL Primary

Addresses

Primary practice location

9555 SW 162ND Ave
Miami, FL 33196-6408

Mailing address

PO Box 198054
Atlanta, GA 30384-8054
Phone (786) 467-2159

Other practice location 1

137 W. Athens St
102
Winder, GA 30680
Phone (770) 867-3208

Other identifiers 2

IdentifierTypeStateIssuer
635315149AMedicaidGA
511I110352OtherGAMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charlese@cerner.directbaptisthealth.com

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
I20120221000845 FL Practitioner - Internal Medicine 1456256304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group Physicians LLCGroup PAC ID 3870696933, 661 clinicians

Practice addresses (Care Compare)

8900 N Kendall Dr
Miami, FL 33176-2118
Phone (786) 596-7670

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
059633GAMDInternal Medicine Physician
ME87673FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Mar 14, 2018 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District CurrentSince Mar 14, 2018 Accepting new patients
Acs Primary Care Physicians - Southeast PC Past Accepting new patients
Carter Emergency Physicians Past Accepting new patients

Locations

1750 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 276-9800

4105 Pembroke Rd
Hollywood, FL 33021
Phone (954) 985-1551

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Organizations & group practices 6

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 1

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1679567580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198054",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848054",
            "telephone_number": "786-467-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 SW 162ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331966408",
            "telephone_number": "786-467-2159",
            "fax_number": "786-533-9703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 W. ATHENS ST",
            "address_2": "102",
            "address_purpose": "LOCATION",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "30680",
            "country_code": "US",
            "telephone_number": "770-867-3208",
            "fax_number": "770-867-3218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EKINDE",
        "first_name": "CHARLES",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "059633",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME87673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "635315149A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "511I110352",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlese@cerner.directbaptisthealth.com",
            "affiliation": "N",
            "address_1": "9555 SW 162nd Ave",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331966408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.