DR. KERRY DIANE THEK M.D.
NPI 1457349417
Pediatrics - Pediatric Gastroenterology in Port Orange, FL

Q: What is Kerry Thek's NPI number?

The NPI number for Kerry Thek is 1457349417. It was assigned to this individual provider in the NPPES registry on October 12, 2005.

Q: What is Kerry Thek's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Q: When was this NPI record last updated?

The NPPES record for Kerry Thek was last updated on May 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 12, 2005PECOS Enrolled

1690 DUNLAWTON AVE STE 120, PORT ORANGE, FL 32127(386) 677-0531(386) 673-4658 Get Directions Write a Review

NPPES record last updated: May 23, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 23, 2018, Mar 22, 2018, Nov 22, 2016 (3 updates tracked since 2016).

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About Dr. Kerry Diane Thek M.d. NPPES

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

DR. KERRY DIANE THEK M.D. (NPI 1457349417) is an individual pediatric gastroenterology provider in Port Orange, Florida, licensed in Florida (ME58396) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457349417

Entity TypeIndividualFemale

Primary Taxonomy2080P0206X

Provider Legal NameDR. KERRY DIANE THEKCredential: M.D.

Location Address1690 DUNLAWTON AVE STE 120Port Orange, FL 32127-8980

Mailing Address1690 Dunlawton Ave Ste 120Port Orange, FL 32127-8980 · (386) 271-2273 · Fax (386) 271-2274

Phone(386) 677-0531

Fax(386) 673-4658

Sole ProprietorNo

Enumeration DateOctober 12, 2005

Last NPPES UpdateMay 23, 20183 updates tracked since enumeration

✔ NPI 1457349417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0206X

Licenses✔ Licensed in FL · ME58396✔ Licensed in AR · E-11212

Definition

A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

1690 DUNLAWTON AVE STE 120, Port Orange, FL 32127

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Other Identifiers 1

Medicaid064841800FL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kerry Diane Thek M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32127 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

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

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

Other Providers at the Same Location NPPES 4

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

DR. AMMAR HEMAIDAN MD

Internal Medicine (Gastroenterology)

1690 DUNLAWTON AVE STE 120
PORT ORANGE, FL 32127

Volusia County (386) 271-2273

TOWN CENTER MEDICAL SERVICES, LLC

Family Medicine

1690 DUNLAWTON AVE STE 120
PORT ORANGE, FL 32127

Volusia County (386) 271-2273

MS. JEANNETTE R DERITA ARNP

Nurse Practitioner (Family)

1690 DUNLAWTON AVE STE 120
PORT ORANGE, FL 32127

Volusia County (386) 449-9650

IMACS, LLC

Internal Medicine (Gastroenterology)

1690 DUNLAWTON AVE STE 120
PORT ORANGE, FL 32127

Volusia County (386) 271-2273

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kerry Thek's NPI number?

The NPI number for Kerry Thek is 1457349417. It was assigned to this individual provider in the NPPES registry on October 12, 2005.

Where is Kerry Thek located?

Kerry Thek practices at 1690 Dunlawton Ave Ste 120, Port Orange, FL 32127. The listed phone number is (386) 677-0531.

What is Kerry Thek's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Is Kerry Thek enrolled in Medicare?

Yes. Kerry Thek is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kerry Thek was last updated on May 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.