Sally Kandah, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME166873 Issued in FL

Practice address

9350 Camelot Dr
Fort Myers, FL 33919-7980

Phone

(239) 481-5437

Fax

(239) 481-0570

NPI assigned

Jun 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Physicians Primary Care of Southwest Florida PL

  • General Practice Physician
  • Fort Myers, FL
  • NPI 1356336705

  Pediatrics

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  NPD

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1922593631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12730 NEW BRITTANY BLVD STE 602",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074690",
            "telephone_number": "239-275-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 CAMELOT DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339197980",
            "telephone_number": "239-481-5437",
            "fax_number": "239-481-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDAH",
        "first_name": "SALLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT216895",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "173971",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME166873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Kaluza
• Megan Kaminski
• Naser Kamkar, M.D.
• Thad Kammerlocher, MD
• Kaitlin Kanaskie
• Scott L Kane, PA-C
• Jean Diane Kanter, RN
• Jenna Rachel Kanter, M.D.
• Jerry Steven Kantor, MD
• Shyam Kapadia, M.D.

• Pediatrics Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.