Individual provider Active NPI

Shiva Kalidindi, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Orlando, FL
National Provider Identifier
1740362417
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
4301080455 Issued in MI
Practice address
1717 S. Orange Ave., Suite 100
Nemours Childrens Clinic
Orlando, FL 32806-2946
Phone
(407) 650-7715
Fax
(407) 650-7124
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 4301080455 MI Primary

Addresses

Primary practice location

1717 S. Orange Ave., Suite 100
Nemours Childrens Clinic
Orlando, FL 32806-2946

Mailing address

P.O. Box 191
Provider Enrollment Department
Rockland, DE 19732-0191
Phone (302) 651-6212

Other names 1

  • Shiva Kumar Raju Kalidindi Other name

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
I20120723000823 FL Practitioner - Emergency Medicine 0042211518 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Jun 25, 2012 Accepting new patients
The Nemours Foundation CurrentSince Jun 25, 2012 Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

1717 S Orange Ave
Ste 100
Orlando, FL 32806

Interoperability endpoints

  • Direct secure messaging: skalidindi40268@direct.nemours.org

Organizations & group practices 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1740362417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S. ORANGE AVE., SUITE 100",
            "address_2": "NEMOURS CHILDRENS CLINIC",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062946",
            "telephone_number": "407-650-7715",
            "fax_number": "407-650-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIDINDI",
        "first_name": "SHIVA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MI",
            "license": "4301080455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIVA KUMAR",
            "last_name": "RAJU KALIDINDI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.