Individual provider Active NPI

Victor Anthony Politano Jr., D.O.

  • Family Medicine Physician
  • Saint Cloud, FL
National Provider Identifier
1063497857
Registry record updated Sep 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS0005193 Issued in FL
Practice address
2155 Nolte Rd
Saint Cloud, FL 34772-8762
Phone
(407) 846-9247
Fax
(407) 846-4430
NPI assigned
Dec 14, 2005
Last updated
Sep 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS0005193 FL Primary

Addresses

Primary practice location

2155 Nolte Rd
Saint Cloud, FL 34772-8762

Mailing address

2155 Nolte Rd
Saint Cloud, FL 34772-8762
Phone (407) 846-9247

Other identifiers 4

IdentifierTypeStateIssuer
062882400MedicaidFL
82904OtherFLBCBS PROVIDER NUMBER
401926OtherFLCIGNA PROVIDER NUMBER
4307838OtherFLAETNA PROVIDER NUMBER

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
I20100416000244 FL Practitioner - Family Practice 7214064641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Physicians and Surgeons (Iowa), 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2155 Nolte Rd
Saint Cloud, FL 34772-8762
Phone (407) 846-9247

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5193FLMDOptometrist
OS0005193FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victor Politano Jr DO PA Family Medicine CurrentSince Feb 3, 2010 Accepting new patients

Locations

1400 W Oak St
Ste D
Kissimmee, FL 34741
Phone (407) 846-9299

2155 Nolte Rd
Saint Cloud, FL 34772
Phone (407) 846-9247

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725753600000",
    "number": "1063497857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 NOLTE RD",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347728762",
            "telephone_number": "407-846-9247",
            "fax_number": "407-846-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 NOLTE RD",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347728762",
            "telephone_number": "407-846-9247",
            "fax_number": "407-846-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITANO",
        "first_name": "VICTOR",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2024-09-08",
        "certification_date": "2024-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0005193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062882400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "82904",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "401926",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "4307838",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.