Luis Emilio Baltodano, MD
Individual provider Active NPI Family Medicine Physician · Celebration, FL
NPI 1013989250 · NPPES record last updated Nov 3, 2020
Key facts
- NPI
- 1013989250
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME69938 (FL)
- Practice address
- 65 Riley Rd
Celebration, FL 34747-5419 - Phone
- (407) 635-3022
- Fax
- (321) 203-4624
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Miami, LM Miller School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Orlando Physicians Network Inc
Practice addresses (Care Compare)
21 Columbia St
Orlando, FL 32806-1133
Phone (321) 841-6600
Hospital & facility affiliations
- Orlando Health
- Orlando Health St Cloud Hospital
- Orlando Health South Lake Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100111000645 | FL | Practitioner - Family Practice | 0244205482 | Reassigns benefits to 1 organization |
| I20200211000323 | TX | Practitioner - Family Practice | 0244205482 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (4 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosebud Indian Health Service | Current |
Accepting new patients | |
| Rosebud Indian Health Service | Current |
Accepting new patients | |
| Orlando Physicians Network Inc | Family Medicine | Current |
Accepting new patients |
| Orlando Health Medical Group Inc | Past | Accepting new patients |
Locations
63 Riley Rd
#4
Celebration, FL 34747
65 Riley Rd
Kissimmee, FL 34747
Phone (407) 635-3022
21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME69938 | FL | Yes |
Addresses
Primary practice location
65 Riley Rd
Celebration, FL 34747-5419
Mailing address
65 Riley Rd
Celebration, FL 34747-5419
Phone (407) 635-3022
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 254673600 | Medicaid | FL |
Other providers in Celebration, FL
- Mohammed Masfikul Azam
- Trevor Rossi Baddaloo
- Maria Imelda Matondo Baguia
- Shanice Baker
- Alan Bako
- Beth Sarah Barbara
- Barefoot Perspectives PLLC
- Miranda Jean Barker
- Kaitlin Dale Barr
- Mackenzie Barton
All providers in Celebration, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.