Individual provider Active NPI

Jorge A Kusnir, M.D.

  • Nephrology Physician
  • Orlando, FL
National Provider Identifier
1063405108
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME0067778 Issued in FL
Practice address
2501 N Orange Ave
Suite 537N
Orlando, FL 32804-4603
Phone
(407) 894-4693
Fax
(407) 896-0569
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME0067778 FL Primary

Addresses

Primary practice location

2501 N Orange Ave
Suite 537N
Orlando, FL 32804-4603

Mailing address

807 S Orlando Ave
Suite C
Winter Park, FL 32789-4870
Phone (407) 894-4693

Other identifiers 4

IdentifierTypeStateIssuer
26635OtherFLBCBS
390003710OtherFLRAILROAD MEDICARE
377188100MedicaidFL
207369OtherFLAVMED

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100210000698 FL Practitioner - Nephrology 1850327842 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0067778FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Central Florida, P.a. Nephrology CurrentSince Mar 17, 1995 Accepting new patients
Dialysis Ser Central Florida LLC PastSince May 1, 2007 Accepting new patients
Renal Access of Central Florida LLC Nephrology Past Accepting new patients

Locations

2501 N Orange Ave
Ste 537N
Orlando, FL 32804
Phone (407) 894-4693

807 S Orlando Ave
Ste C
Winter Park, FL 32789
Phone (407) 894-4693

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1063405108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 S ORLANDO AVE",
            "address_2": "SUITE C",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894870",
            "telephone_number": "407-894-4693",
            "fax_number": "407-539-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE",
            "address_2": "SUITE 537N",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-894-4693",
            "fax_number": "407-896-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSNIR",
        "first_name": "JORGE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME0067778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26635",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390003710",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377188100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "207369",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.