Individual provider Active NPI

Kathleen Vazzana, DO

  • Pediatric Rheumatology Physician
  • Orlando, FL
National Provider Identifier
1083097521
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
OS17693 Issued in FL
Practice address
1802 Kuhl Ave Ste 101
Orlando, FL 32806-2004
Phone
(321) 843-9400
Fax
(321) 841-5781
NPI assigned
Jul 1, 2015
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X UO 4550 FL
Pediatric Rheumatology Physician 2080P0216X OS17693 FL Primary

Addresses

Primary practice location

1802 Kuhl Ave Ste 101
Orlando, FL 32806-2004

Mailing address

1802 Kuhl Ave Ste 101
Orlando, FL 32806-2004
Phone (321) 843-9400

Other practice location 1

83 Columbia St
Orlando, FL 32806-1101
Phone (321) 843-3220

Other identifiers 1

IdentifierTypeStateIssuer
110330100MedicaidFL

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
I20210617002213 FL Practitioner - RheumatologyPractitioner - Pediatric Medicine 9032425277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS17693FLMDPediatric Rheumatology Physician
UO 4550FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2021 Accepting new patients

Locations

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

1802 Kuhl Ave
Ste 101
Orlando, FL 32806
Phone (321) 843-9400

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

83 Columbia St
Orlando, FL 32806
Phone (321) 843-3220

86 Underwood St
Ste 202
Orlando, FL 32806

Interoperability endpoints

  • Direct secure messaging: kvazzana245985@orlandohealth.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1083097521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 KUHL AVE STE 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062004",
            "telephone_number": "321-843-9400",
            "fax_number": "321-841-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 KUHL AVE STE 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062004",
            "telephone_number": "321-843-9400",
            "fax_number": "321-841-5781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "83 Columbia St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061101",
            "country_code": "US",
            "telephone_number": "321-843-3220",
            "fax_number": "321-843-3210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZZANA",
        "first_name": "KATHLEEN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO 4550",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "FL",
            "license": "OS17693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110330100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.