Individual provider Active NPI

Bridget M Kinane, PA

  • Medical Physician Assistant
  • Bradenton, FL
National Provider Identifier
1982680435
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9101156 Issued in FL
Practice address
315 75TH St W
Bradenton, FL 34209-3201
Phone
(941) 761-1616
Fax
(941) 761-3807
NPI assigned
Dec 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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 PA9101156 FL Primary

Addresses

Primary practice location

315 75TH St W
Bradenton, FL 34209-3201

Mailing address

315 75TH St W
Bradenton, FL 34209-3201
Phone (941) 761-1998

Other identifiers 3

IdentifierTypeStateIssuer
970026428OtherRAILROAD MEDICARE
291574000MedicaidFL
P00121613OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071217000812 FL Practitioner - Physician Assistant 2567552375 Reassigns benefits to 2 organizations
I20180123003100 NM Practitioner - Physician Assistant 2567552375 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Feb 1, 2018 Accepting new patients
FL-I Medical Services, LLC CurrentSince Jan 1, 2015 Accepting new patients
Presbyterian Healthcare Services CurrentSince Feb 1, 2018 Accepting new patients
Legacy Mount Hood Medical Center Past Accepting new patients
Sarasota Emergency Associates PA Past Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

Organizations & group practices 7

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1982680435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 75TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093201",
            "telephone_number": "941-761-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 75TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093201",
            "telephone_number": "941-761-1616",
            "fax_number": "941-761-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINANE",
        "first_name": "BRIDGET",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970026428",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291574000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00121613",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.