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SANDFORD H KINNE III D O P A
NPI 1942435920
Family Medicine in Ormond Beach, FL

Active since May 20, 2009
290 CLYDE MORRIS BLVD, SUITE A-1, ORMOND BEACH, FL 32174(386) 677-5600(386) 677-5686 Get Directions Write a Review

NPPES record last updated: May 20, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sandford H Kinne Iii D O P A NPPES

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

SANDFORD H KINNE III D O P A (NPI 1942435920) is a healthcare organization registered as a family medicine in Ormond Beach, Florida and active in the NPI registry since May 2009. The organization lists Sandford Halsey Kinne, Owner/self, as its authorized official.

NPPES Registry Identity

NPI1942435920
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSANDFORD H KINNE III D O P A
Location Address290 CLYDE MORRIS BLVD, SUITE A-1Ormond Beach, FL 32174-8130
Mailing AddressPo Box 731869Ormond Beach, FL 32173-1869 · (386) 677-5600 · Fax (386) 677-5686
Phone(386) 677-5600
Fax(386) 677-5686
Organization SubpartNo
Authorized OfficialSandford Halsey KinneOwner/self · (386) 677-5600
Enumeration DateMay 20, 2009
✔ NPI 1942435920 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · OS0006791
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
290 CLYDE MORRIS BLVD, Ormond Beach, FL 32174
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Other Identifiers 2

Medicare UPINF06783FL
Medicaid375409000FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sandford H Kinne Iii D O P A is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateFloridaEnrollment IDO20090616000324Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sandford H Kinne III D O P A, which bills Medicare for the services this clinician delivers.

Clinician (1)

Sandford Kinne, DO
Family Practice
NPI 1043328735
290 CLYDE MORRIS BLVD SUITE A-1
Ormond Beach, FL 32174
(386) 677-5600
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Sandford H Kinne III D O P A's NPI number?

The NPI number for Sandford H Kinne III D O P A is 1942435920. It was assigned to this organization in the NPPES registry on May 20, 2009.

Where is Sandford H Kinne III D O P A located?

Sandford H Kinne III D O P A is located at 290 Clyde Morris Blvd Suite A-1, Ormond Beach, FL 32174. The listed phone number is (386) 677-5600.

What is Sandford H Kinne III D O P A's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sandford H Kinne III D O P A enrolled in Medicare?

Yes. Sandford H Kinne III D O P A is registered in the Medicare PECOS enrollment system.

When is Sandford H Kinne III D O P A's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Sandford H Kinne III D O P A?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Sandford H Kinne III D O P A. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Sandford H Kinne III D O P A was last updated on May 20, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.