Individual provider Active NPI

Halide Kattan, MD

  • Internal Medicine Physician
  • Brandon, FL
National Provider Identifier
1689658957
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0076926 Issued in FL
Practice address
1111 Lithia Pinecrest Rd
Brandon, FL 33511-6713
Phone
(813) 643-3242
Fax
(813) 643-3090
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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 ME0076926 FL Primary

Addresses

Primary practice location

1111 Lithia Pinecrest Rd
Brandon, FL 33511-6713

Mailing address

2600 S Douglas Rd Ste 308
Coral Gables, FL 33134-6134
Phone (305) 913-9441

Other identifiers 1

IdentifierTypeStateIssuer
255317100MedicaidFL

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
I20110104000492 FL Practitioner - Internal Medicine 1557550761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Medical Specialists LLCGroup PAC ID 5799786687, 125 clinicians

Practice addresses (Care Compare)

1111 Lithia Pinecrest Rd
Brandon, FL 33511-6713
Phone (813) 643-3242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0076926FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Specialists LLC CurrentSince Nov 25, 2024 Accepting new patients
Florida Medical Specialists LLC CurrentSince Nov 25, 2024 Accepting new patients
Florida Medical Specialists LLC Current Accepting new patients
Florida Medical Associates LLC PastSince Apr 3, 2023 Accepting new patients
Best Value Healthcare LLC Internal Medicine Past Accepting new patients
Primary Medical Care R Ayala MD PA PastSince Jul 20, 2009 Accepting new patients

Locations

1111 Lithia Pinecrest Rd
Brandon, FL 33511
Phone (813) 643-3242

3830 Bee Ridge Rd
Ste 301
Sarasota, FL 34233
Phone (941) 923-1872

3830 Bee Ridge Rd
Ste 100
Sarasota, FL 34233
Phone (941) 921-0383

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1689658957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S DOUGLAS RD STE 308",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346134",
            "telephone_number": "305-913-9441",
            "fax_number": "305-442-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LITHIA PINECREST RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116713",
            "telephone_number": "813-643-3242",
            "fax_number": "813-643-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATTAN",
        "first_name": "HALIDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0076926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255317100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.