Individual provider Active NPI

Kandace Marisa Kichler, MD

  • Surgery Physician
  • Miami Beach, FL
National Provider Identifier
1861768848
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME132896 Issued in FL
Practice address
1111 Lincoln Rd Ste 800
Miami Beach, FL 33139-2451
Phone
(305) 391-2173
NPI assigned
Mar 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME132896 FL Primary
Obesity Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RB0002X ME132896 FL

Addresses

Primary practice location

1111 Lincoln Rd Ste 800
Miami Beach, FL 33139-2451

Mailing address

10752 Northbrook Cir
Palm Beach Gardens, FL 33412-7307
Phone (561) 568-5801

Other identifiers 1

IdentifierTypeStateIssuer
021449500MedicaidFL

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": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1861768848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10752 NORTHBROOK CIR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334127307",
            "telephone_number": "561-568-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LINCOLN RD STE 800",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331392451",
            "telephone_number": "305-391-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICHLER",
        "first_name": "KANDACE",
        "middle_name": "MARISA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME132896",
            "primary": true
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "FL",
            "license": "ME132896",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021449500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.