Individual provider Active NPI

Dimitrios Michael Kalomiris, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Delray Beach, FL
National Provider Identifier
1861585721
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME58653 Issued in FL
Practice address
1300 NW 17TH Ave
Suite 130
Delray Beach, FL 33445-2578
Phone
(561) 819-0857
Fax
(561) 549-0173
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME58653 FL Primary

Addresses

Primary practice location

1300 NW 17TH Ave
Suite 130
Delray Beach, FL 33445-2578

Mailing address

2600 Lake Lucien Dr
Suite 180
Maitland, FL 32751-7233
Phone (407) 875-2080

Other identifiers 1

IdentifierTypeStateIssuer
276920400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1861585721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 LAKE LUCIEN DR",
            "address_2": "SUITE 180",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517233",
            "telephone_number": "407-875-2080",
            "fax_number": "407-875-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 NW 17TH AVE",
            "address_2": "SUITE 130",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334452578",
            "telephone_number": "561-819-0857",
            "fax_number": "561-549-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALOMIRIS",
        "first_name": "DIMITRIOS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME58653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276920400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.