Individual provider Active NPI

Brian John Kiedrowski, M.D., C.M.D

  • Geriatric Medicine (Internal Medicine) Physician
  • Miami, FL
National Provider Identifier
1891851275
Registry record updated Dec 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME0065376 Issued in FL
Practice address
5200 NE 2ND Ave
Miami, FL 33137-2706
Phone
(305) 795-8494
Fax
(305) 762-1392
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME0065376 FL Primary

Addresses

Primary practice location

5200 NE 2ND Ave
Miami, FL 33137-2706

Mailing address

5200 NE 2ND Ave
Miami, FL 33137-2706
Phone (305) 795-8494

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
I20101014001362 FL Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 5193918712 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0065376FLMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Services Inc CurrentSince Dec 8, 2021 Accepting new patients
Anchor Health Centers PA Past Accepting new patients

Locations

3075 NW 35th Ave
Lauderdale Lakes, FL 33311
Phone (954) 486-9676

3487 NW 30th St
Lauderdale Lakes, FL 33311
Phone (954) 641-4200

1050 NE 125th St
North Miami, FL 33161
Phone (305) 357-1735

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/cybermed_chs
  • Direct secure messaging: bkiedrowski51402@direct.med.miami.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293667200000",
    "number": "1891851275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 NE 2ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331372706",
            "telephone_number": "305-795-8494",
            "fax_number": "305-762-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 NE 2ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331372706",
            "telephone_number": "305-795-8494",
            "fax_number": "305-762-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEDROWSKI",
        "first_name": "BRIAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D., C.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2010-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME0065376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.