Individual provider Active NPI

Kabbinamane V Dharmappa, M.D.

  • Pediatrics Physician
  • Ft Lauderdale, FL
National Provider Identifier
1700885688
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME Issued in FL
Practice address
1319 SE 2ND Ave
Ft Lauderdale, FL 33316-1809
Phone
(954) 452-7576
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME FL Primary

Addresses

Primary practice location

1319 SE 2ND Ave
Ft Lauderdale, FL 33316-1809

Mailing address

1319 SE 2ND Ave
Ft Lauderdale, FL 33316-1809
Phone (954) 452-7576

Other identifiers 6

IdentifierTypeStateIssuer
065783200MedicaidFL
200363OtherFLAMERIGROUP
93929OtherFLBLUE CROSS BLUE SHIELD
ME0037089OtherFLVISTA HEALTH PLANS
209967OtherFLAVMED
4220597OtherFLAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
East/West Pediatrics, P.a. Pediatrics Past Accepting new patients

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1700885688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 SE 2ND AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161809",
            "telephone_number": "954-452-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 SE 2ND AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161809",
            "telephone_number": "954-452-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHARMAPPA",
        "first_name": "KABBINAMANE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065783200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "200363",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "93929",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISTA HEALTH PLANS",
            "identifier": "ME0037089",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "209967",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4220597",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.