Individual provider Active NPI

Kathleen Melendez, MD

  • Internal Medicine Physician
  • Coral Gables, FL
National Provider Identifier
1679887632
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME133991 Issued in FL
Practice address
5555 Ponce de Leon Blvd Ste 128
Coral Gables, FL 33146-2513
Phone
(305) 284-9100
Fax
(305) 284-4098
NPI assigned
Aug 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 54650 CT
Internal Medicine Physician 207R00000X 0101254755 VA
Internal Medicine Physician 207R00000X ME133991 FL Primary

Addresses

Primary practice location

5555 Ponce de Leon Blvd Ste 128
Coral Gables, FL 33146-2513

Mailing address

5555 Ponce de Leon Blvd
Coral Gables, FL 33146-2513
Phone (305) 284-9100

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
I20180405000728 FL Practitioner - Internal Medicine 7618110099 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME133991FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Group of South Florida PA Internal Medicine CurrentSince Feb 19, 2018 Accepting new patients

Locations

4308 Alton Rd
Ste 710
Miami Beach, FL 33140
Phone (305) 674-5925

1801 NE 123rd St
Ste 405
North Miami, FL 33181
Phone (305) 674-5925

Interoperability endpoints

  • Direct secure messaging: kathleen.melendez@pgsfl.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61137

Organizations & group practices 1

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": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1679887632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462513",
            "telephone_number": "305-284-9100",
            "fax_number": "305-284-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PONCE DE LEON BLVD STE 128",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462513",
            "telephone_number": "305-284-9100",
            "fax_number": "305-284-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "54650",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101254755",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME133991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.