Individual provider Active NPI

Prakash Diptee, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Coral Gables, FL
National Provider Identifier
1861478950
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
ME67024 Issued in FL
Practice address
5955 Ponce de Leon Blvd.
Coral Gables, FL 33146
Phone
(305) 661-1515
Fax
(305) 662-3723
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME67024 FL
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X ME67024 FL Primary

Addresses

Primary practice location

5955 Ponce de Leon Blvd.
Coral Gables, FL 33146

Mailing address

5955 Ponce de Leon Blvd.
Coral Gables, FL 33146
Phone (305) 661-1515

Other identifiers 1

IdentifierTypeStateIssuer
379189100MedicaidFL

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
I20160926002027 FL Practitioner - Pediatric Medicine 5890082408 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME67024FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Pediatric Services, PA CurrentSince Jun 12, 2016 Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

5955 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 662-8668

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1861478950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD.",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33146",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD.",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33146",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPTEE",
        "first_name": "PRAKASH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME67024",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME67024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379189100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.