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KENNETH A. BERDICK, M.D., P.A.
NPI 1508125170
Internal Medicine in Fort Myers, FL

Active since May 16, 2012CLIA 10D0701024 · Waiver
3714 EVANS AVE, FORT MYERS, FL 33901(239) 334-4157(239) 334-1904 Get Directions Write a Review

NPPES record last updated: September 24, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kenneth A. Berdick, M.d., P.a. NPPES

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

KENNETH A. BERDICK, M.D., P.A. (NPI 1508125170) is a healthcare organization registered as an internal medicine in Fort Myers, Florida and active in the NPI registry since May 2012. The organization holds a CLIA Waiver certificate valid through December 20, 2026 and lists Kenneth A Berdick, President, as its authorized official.

NPPES Registry Identity

NPI1508125170
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameKENNETH A. BERDICK, M.D., P.A.
Location Address3714 EVANS AVEFort Myers, FL 33901-9303
Mailing Address3714 Evans AveFort Myers, FL 33901-9303 · (239) 334-4157 · Fax (239) 334-1904
Phone(239) 334-4157
Fax(239) 334-1904
Organization SubpartNo
Authorized OfficialKenneth A BerdickPresident · (239) 334-4157
Enumeration DateMay 16, 2012
Last NPPES UpdateSeptember 24, 2012
✔ NPI 1508125170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME0017772
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X · License NP1971252 (FL)
3714 EVANS AVE, Fort Myers, FL 33901
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Other Identifiers 3

Other91309FL · Medicare Ptan
Medicaid066122800FL
Medicare UPIND59582FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Baylor Scott and White Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0701024

Kenneth A Berdick MD · Fort Myers, FL
Active · expires Dec 20, 2026
CLIA Number10D0701024
Laboratory TypePhysician Office
Certificate Effective DateDecember 21, 2024
Certificate Expiration DateDecember 20, 2026
Laboratory DirectorKenneth A. Berdick
Laboratory Phone(239) 334-4157
Laboratory LocationKenneth A Berdick MD3714 Evans Ave, Fort Myers, FL 33901
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Kenneth A. Berdick, M.D., P.A.'s NPI number?

The NPI number for Kenneth A. Berdick, M.D., P.A. is 1508125170. It was assigned to this organization in the NPPES registry on May 16, 2012.

Where is Kenneth A. Berdick, M.D., P.A. located?

Kenneth A. Berdick, M.D., P.A. is located at 3714 Evans Ave, Fort Myers, FL 33901. The listed phone number is (239) 334-4157.

What is Kenneth A. Berdick, M.D., P.A.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Kenneth A. Berdick, M.D., P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0701024) is associated with this NPI, valid through December 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kenneth A. Berdick, M.D., P.A. accept?

Health plans from Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Baylor Scott and White Health Plan and Moda Health Plan, Inc. list Kenneth A. Berdick, M.D., P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kenneth A. Berdick, M.D., P.A. was last updated on September 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.