Individual provider Active NPI

Kenneth Lim, MD

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1881659308
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME74038 Issued in FL
Practice address
7242 W Colonial Dr
Orlando, FL 32818-6749
Phone
(407) 296-2273
Fax
(407) 294-9740
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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 ME74038 FL Primary

Addresses

Primary practice location

7242 W Colonial Dr
Orlando, FL 32818-6749

Mailing address

7242 W Colonial Dr
Orlando, FL 32818-6749
Phone (407) 296-2273

Other identifiers 1

IdentifierTypeStateIssuer
277568900MedicaidFL

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
I20040605000161 FL Practitioner - Family Practice 2365424041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Miami, LM Miller School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

1345 W Bay Dr
202 Optum Largo
Largo, FL 33770-2276
Phone (727) 559-0895

7242 W Colonial Dr
Optum West Colonial
Orlando, FL 32818-6749
Phone (407) 296-2273

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida, LLC CurrentSince Oct 1, 2005 Accepting new patients
Optumcare Florida LLC Family Medicine CurrentSince Oct 1, 2005 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

515 W State Road 434
Ste 301
Longwood, FL 32750
Phone (407) 331-9744

7242 W Colonial Dr
Orlando, FL 32818
Phone (407) 296-2273

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kenneth.lim@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1881659308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7242 W COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328186749",
            "telephone_number": "407-296-2273",
            "fax_number": "407-294-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7242 W COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328186749",
            "telephone_number": "407-296-2273",
            "fax_number": "407-294-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME74038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277568900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.