Kelly Mudon

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS16971 Issued in FL

Practice address

10300 SW 216TH St
Miami, FL 33190-3319

Phone

(786) 293-5502

NPI assigned

Apr 3, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health of South Florida IncGroup PAC ID 6507770526, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Community Health of South Florida Inc

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
  • NPI 1336152347

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Community Health of South Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Key Largo, FL
  • NPI 1417704198
  NPD
• Community Health of South Florida, Inc.

  • Federally Qualified Health Center (FQHC)
  • Naranja, FL
  • NPI 1023271855
  NPD (past)

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1699207076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1662 L1/2 RD.",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "81521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331903319",
            "telephone_number": "786-293-5502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1662 L1/2 Rd.",
            "address_purpose": "LOCATION",
            "city": "Fruita",
            "state": "CO",
            "postal_code": "81521",
            "country_code": "US",
            "telephone_number": "970-270-1292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUDON",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS16971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Muchayi, M.D
• Burij Muchnik, P.A.
• Lisett Muci, B.A
• Nariman Muci, ARNP
• Raja Mudad, MD
• Anna Mudrytska
• Stephanie Muffett, LMHC
• Richard Alan Mufson, DDS
• Niurka Mugica
• Vanessa Arteaga Mugnai, CRNA

• Family Medicine Physician in Miami, FL
• Providers in Miami, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.