Sergio San Jose, D.O.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

OS12497 Issued in FL

Practice address

2620 W 76TH St Apt 206
Hialeah, FL 33016-5649

Phone

(786) 897-0578

NPI assigned

Apr 1, 2011

Last updated

Oct 18, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Infectious Disease

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sji Medical PAGroup PAC ID 8729325600, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Palmetto General Hospital Hospital, Hialeah, FL, CCN 100187

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sji Medical, P.a.

  • Infectious Disease Physician
  • Pembroke Pines, FL
  • NPI 1366932527
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hsa PGH LLC

  dba Palmetto General Hospital

  • General Acute Care Hospital
  • Hialeah, FL
  • NPI 1881412740
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1023307832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 W 76TH ST APT 206",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165649",
            "telephone_number": "786-897-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 W 76TH ST APT 206",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165649",
            "telephone_number": "786-897-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN JOSE",
        "first_name": "SERGIO",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "OS12497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Elizabeth Samuels Merlin
• Samy Nursing Corp
• Elena Martha San Emeterio, ARNP
• Evaristo San Jose Alvarez, MD
• Sheila San Jose Izquierdo, RBT
• Yudelkys San Juan Machin, APRN
• San Judas Home for the Elderly
• San Judas Home for the Elderly Inc
• San Judas Love and Care Inc
• San Judas Medical Centers Inc

• Infectious Disease Physician in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Infectious Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.