Individual provider Active NPI

Keniel Felix Pierre, M.D.

  • Cardiovascular Disease Physician
  • New Smyrna Beach, FL
National Provider Identifier
1790170918
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME139763 Issued in FL
Practice address
600 Palmetto St
New Smyrna Beach, FL 32168-7327
Phone
(386) 615-1521
NPI assigned
Apr 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35600 AL
Cardiovascular Disease Physician 207RC0000X ME139763 FL Primary

Addresses

Primary practice location

600 Palmetto St
New Smyrna Beach, FL 32168-7327

Mailing address

103 Memorial Medical Pkwy Ste 200
Daytona Beach, FL 32117-5121
Phone (386) 615-1521

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
I20190619001545 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6709182371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Florida State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Physicians Memorial, LLCGroup PAC ID 2567622954, 13 clinicians

Practice addresses (Care Compare)

103 Memorial Medical Pkwy
Suite 200
Daytona Beach, FL 32117-5121
Phone (386) 615-1521

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.22 of 100Reported as group
Quality
94.03
Promoting interoperability
97
Improvement activities
40
Cost
75.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting18
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35600ALMDInternal Medicine Physician
ME139763FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc CurrentSince Aug 2, 2024 Accepting new patients
Cardiology Physicians Memorial, LLC Cardiovascular Disease CurrentSince Aug 1, 2024 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

305 Memorial Medical Pkwy
Ste 301
Daytona Beach, FL 32117
Phone (386) 231-4450

103 Memorial Medical Pkwy
Ste 200
Daytona Beach, FL 32117
Phone (386) 615-1521

600 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 424-3850

1041 Dunlawton Ave
Pt Orange, FL 32127
Phone (386) 322-4700

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1790170918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MEMORIAL MEDICAL PKWY STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175121",
            "telephone_number": "386-615-1521",
            "fax_number": "386-671-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687327",
            "telephone_number": "386-615-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "KENIEL",
        "middle_name": "FELIX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "35600",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME139763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.