Individual provider Active NPI

Cygethia Gayle Kankam, M.D

  • Family Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1841361144
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME74260 Issued in FL
Practice address
2015 Ocean Dr Ste 11
Boynton Beach, FL 33426-5131
Phone
(561) 364-8056
Fax
(561) 364-8507
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME74260 FL Primary

Addresses

Primary practice location

2015 Ocean Dr Ste 11
Boynton Beach, FL 33426-5131

Mailing address

2015 Ocean Dr Ste 11
Boynton Beach, FL 33426-5131
Phone (561) 364-8056

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
I20110201000355 FL Practitioner - Family Practice 5092994459

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dobremed,LLC PastSince Dec 8, 2024 Accepting new patients
South Florida Medical Centers, Inc Family Medicine PastSince Jul 14, 2014 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1841361144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 OCEAN DR STE 11",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334265131",
            "telephone_number": "561-364-8056",
            "fax_number": "561-364-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 OCEAN DR STE 11",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334265131",
            "telephone_number": "561-364-8056",
            "fax_number": "561-364-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANKAM",
        "first_name": "CYGETHIA",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME74260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.