Individual provider Active NPI

Angela Kinderman, MMS, PA-C

  • Physician Assistant
  • Davie, FL
National Provider Identifier
1851720387
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51390 Issued in CA
Practice address
2840 SW 75TH Way Apt 2410
Davie, FL 33314-1032
Phone
(715) 210-6855
NPI assigned
Nov 5, 2013
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51390 CA Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

2840 SW 75TH Way Apt 2410
Davie, FL 33314-1032

Mailing address

2840 SW 75TH Way
Apt 2410
Davie, FL 33314-1032
Phone (715) 210-6855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140519000581 CA Practitioner - Physician Assistant 9335362441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51390CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Feb 1, 2014 Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients

Locations

2540 East St
Concord, CA 94520
Phone (925) 674-2228

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

900 Hyde St
San Francisco, CA 94109
Phone (415) 353-6000

Interoperability endpoints

  • Direct secure messaging: akinderman439447@direct-ucsfmedicalcenter.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1851720387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 SW 75TH WAY",
            "address_2": "APT 2410",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333141032",
            "telephone_number": "715-210-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 SW 75TH WAY APT 2410",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333141032",
            "telephone_number": "715-210-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDERMAN",
        "first_name": "ANGELA",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51390",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.