NPIMap

Individual provider Active NPI

Jose Ramon Fernandez, M.D.

  • Family Medicine Physician
  • Kissimme, FL
National Provider Identifier
1063516284
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME63085 Issued in FL
Practice address
300 N. John Young Pkwy
Kissimme, FL 34141
Phone
(407) 935-9012
Fax
(407) 935-9108
NPI assigned
Sep 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME63085 FL
Family Medicine Physician 207Q00000X ME63085 FL Primary

Addresses

Primary practice location

300 N. John Young Pkwy
Kissimme, FL 34141

Mailing address

300 N. John Young Pkwy
Kissimme, FL 34141
Phone (407) 935-9012

Other practice location 1

2040 Highway A1A Ste 209
Indian Harbour Beach, FL 32937-3566
Phone (321) 425-2233

Other identifiers 1

IdentifierTypeStateIssuer
371432201MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000619 FL Practitioner - Family Practice 4880623636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

300 N John Young Pkwy
Kissimmee, FL 34741-4902
Phone (407) 935-9012

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.66 of 100Reported as individual
Quality
84.84
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME63085FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JMJ Family Practice Inc Family Medicine CurrentSince Aug 1, 2005 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2040 Highway A1A
Ste 209
Indian Harbour Beach, FL 32937
Phone (321) 425-2233

300 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 935-9012

Interoperability endpoints

  • Direct secure messaging: jose.fernandez.1@10787.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/10787/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1063516284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N. JOHN YOUNG PKWY",
            "city": "KISSIMME",
            "state": "FL",
            "postal_code": "34141",
            "telephone_number": "407-935-9012",
            "fax_number": "407-935-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N. JOHN YOUNG PKWY",
            "city": "KISSIMME",
            "state": "FL",
            "postal_code": "34141",
            "telephone_number": "407-935-9012",
            "fax_number": "407-935-9108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 Highway A1A Ste 209",
            "address_purpose": "LOCATION",
            "city": "Indian Harbour Beach",
            "state": "FL",
            "postal_code": "329373566",
            "country_code": "US",
            "telephone_number": "321-425-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JOSE",
        "middle_name": "RAMON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME63085",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME63085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371432201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimme, FL

Sources for this page

Verify at the official NPI Registry.