David J. Kaderis, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

OS12384 Issued in FL

Practice address

5149 N 9TH Ave
Suite 246
Pensacola, FL 32504-8756

Phone

(850) 416-6159

Fax

(850) 416-7198

NPI assigned

Jun 15, 2006

Last updated

Mar 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MT, FL2 enrollments

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 2

Specialty

General Surgery

Education

Rowan University School of Osteopathic Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holy Rosary HealthcareGroup PAC ID 8921045667, 49 clinicians

Sacred Heart Health System, IncGroup PAC ID 5799763074, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
• Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292
• Holy Rosary Hospital Hospital, Miles City, MT, CCN 271347

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: david.kaderis.1@9582.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sacred Heart Health System, Inc.

  dba Ascension Medical Group Sacred Heart Sub Specialists

  • Neurological Surgery Physician
  • Pensacola, FL
  • NPI 1902857352
  Medicare reassignment Care Compare group
• Holy Rosary Healthcare

  dba Baker Clinic - OB-GYN

  • Clinic/Center
  • Miles City, MT
  • NPI 1225201825
  Medicare reassignment Care Compare group
• Rosebud Community Hospital Inc

  dba Rosebud Medical Center Rural Health Clinic

  • Rural Health Clinic/Center
  • Forsyth, MT
  • NPI 1164617031
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

• Ascension Sacred Heart Emerald Coast

  • General Acute Care Hospital
  • Miramar Beach, FL
  • NPI 1558391771
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  dba Ascension Sacred Heart Pensacola

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation
• Holy Rosary Healthcare

  dba Intermountain Health Holy Rosary Hospital

  • Critical Access Hospital
  • Miles City, MT
  • NPI 1396074548
  Care Compare affiliation

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1922042738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "fax_number": "850-475-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5149 N 9TH AVE",
            "address_2": "SUITE 246",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048756",
            "telephone_number": "850-416-6159",
            "fax_number": "850-416-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADERIS",
        "first_name": "DAVID",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS12384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010322300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ka'Dira Carey (Trusted Coneections Therapeutic Services)
• Sonja Ann Kabella, COTA
• Patricia Kachur
• Sergey Kachur, M.D.
• Korin Kaczocha, DDS
• Arianna Kae
• Fernando E. Kafie, MD
• Barbara J Kahalley, ST
• Frances Lee Kahler-Ropp, LCSW
• Rachel Kaiser, L.AC, DACOM

• Surgery Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.