Individual provider Active NPI

Kay Mekadenaumporn, P.A.

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1942551056
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9106817 Issued in FL
Practice address
5058 S Conway Rd
Orlando, FL 32812-1258
Phone
(407) 851-2790
NPI assigned
Sep 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 9106817 FL Primary

Addresses

Primary practice location

5058 S Conway Rd
Orlando, FL 32812-1258

Mailing address

5058 S Conway Rd
Orlando, FL 32812-1258

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140815000759 FL Practitioner - Physician Assistant 3779700786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.2 of 100Reported as group
Quality
78.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9106817FLMDMedical Physician Assistant

Organizations & group practices 1

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": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1942551056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5058 S CONWAY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328121258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5058 S CONWAY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328121258",
            "telephone_number": "407-851-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKADENAUMPORN",
        "first_name": "KAY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9106817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.