KETAN A KAPADIA M.D.
NPI 1043274152
Urology in St Petersburg, FL

Q: What is Ketan Kapadia's NPI number?

The NPI number for Ketan Kapadia is 1043274152. It was assigned to this individual provider in the NPPES registry on April 14, 2006.

Q: What is Ketan Kapadia's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Ketan Kapadia was last updated on January 20, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 14, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

5747 38TH AVE N, ST PETERSBURG, FL 33710(727) 381-8667(727) 345-1951 Get Directions Write a Review

NPPES record last updated: January 20, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 20, 2021, Sep 23, 2020 (2 updates tracked since 2020).

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About Ketan A Kapadia M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETAN A KAPADIA M.D. (NPI 1043274152) is an individual urology provider in St Petersburg, Florida, licensed in Florida (ME79719) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Pasadena Hospital, and is a graduate of University Of California, San Francisco School Of Medicine (1993).

NPPES Registry Identity

NPI1043274152

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameKETAN A KAPADIACredential: M.D.

Location Address5747 38TH AVE NSt Petersburg, FL 33710-1925

Mailing Address12109 County Road 103Oxford, FL 34484-2951 · (352) 205-8981 · Fax (352) 391-6498

Phone(727) 381-8667

Fax(727) 345-1951

Sole ProprietorNo

Medical School CMSUniversity Of California, San Francisco School Of MedicineGraduated 1993

Enumeration DateApril 14, 2006

Last NPPES UpdateJanuary 20, 20212 updates tracked since enumeration

NPPES CertifiedJanuary 20, 2021

✔ NPI 1043274152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in FL · ME79719

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

5747 38TH AVE N, St Petersburg, FL 33710

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ketan A Kapadia M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446320758

PECOS Enrollment IDI20080529000697

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 32

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, testosterone undecanoate, 1 mg J3145

Testosterone undecanoate is a medication given through injection to help regulate hormone levels in the body. It's typically used when the body doesn't produce enough of a certain hormone on its own. The dosage is 1 mg.

80,250 services26 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

1,680 services597 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

1,478 services582 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

687 services442 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

591 services387 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

297 services80 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

253 services209 patients

Limited ultrasound scan behind abdominal cavity 76775

A limited ultrasound scan behind the abdominal cavity is a non-invasive imaging method that helps visualize structures in the back of your abdomen. This procedure uses sound waves to create pictures of these areas, assisting in diagnosing certain conditions.

244 services207 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

230 services96 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

183 services34 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

144 services106 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

117 services106 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

116 services91 patients

Leuprolide acetate (for depot suspension), 7.5 mg J9217

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

116 services14 patients

Limited ultrasound scan of abdomen 76705

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

107 services80 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

104 services86 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

72 services18 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

62 services27 patients

Other procedure on male genital system 55899

This procedure refers to a variety of medical interventions on the male reproductive system. It could be diagnostic, therapeutic, or preventive. It's done to maintain or improve reproductive health. It's always performed by a skilled medical professional.

55 services53 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

54 services54 patients

Injection, ertapenem sodium, 500 mg J1335

Ertapenem sodium is a potent antibiotic administered via injection to treat a variety of serious bacterial infections. The 500 mg dosage helps your body fight off these bacteria effectively. It's given by a healthcare professional, often in a hospital setting.

54 services15 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

49 services24 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

44 services43 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

44 services17 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

34 services33 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

28 services28 patients

Dilation of urethra using an endoscope 52281

This procedure involves expanding a narrow passage in your urinary tract with the help of a special instrument called an endoscope. It aids in improving urine flow and resolving related issues, ensuring better urinary health.

22 services16 patients

Injection, garamycin, gentamicin, up to 80 mg J1580

This procedure involves administering an injection of Gentamicin, also known as Garamycin, up to a dose of 80 mg. Gentamicin is an antibiotic used to treat a wide variety of bacterial infections. It works by stopping the growth of bacteria.

21 services11 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

19 services19 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

15 services14 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

13 services12 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

13 services13 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hca Florida Pasadena Hospital

Acute Care Hospitals · Saint Petersburg, FL

3/5 CMS rating

OwnershipProprietary

CMS Certification Number100126

Location1501 Pasadena Ave SSaint Petersburg, FL 33707 · Pinellas County

Emergency services

Morton Plant Hospital

Acute Care Hospitals · Clearwater, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100127

Location300 Pinellas StClearwater, FL 33756 · Pinellas County

Emergency services Birthing friendly

Hca Florida St Petersburg Hospital

Acute Care Hospitals · Saint Petersburg, FL

2/5 CMS rating

OwnershipProprietary

CMS Certification Number100180

Location6500 38th Ave NSaint Petersburg, FL 33710 · Pinellas County

Emergency services Birthing friendly

Hca Florida Northside Hospital

Acute Care Hospitals · Saint Petersburg, FL

1/5 CMS rating

OwnershipProprietary

CMS Certification Number100238

Location6000 49th St NSaint Petersburg, FL 33709 · Pinellas County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33710 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lubricant, individual sterile packet, each A4332

DME-Medical/Surgical Supplies · category DA000N

2 suppliers19 claims2,830 services$0.11 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

4 suppliers42 claims10,300 services$1.74 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

4 suppliers42 claims7,230 services$5.18 avg. paid by Medicare

Lubricant, per ounce A4402

DME-Orthotic Devices · category DF010N

2 suppliers14 claims80 services$1.37 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RISHI ASHOK MODH M.D.

Urology