Individual provider Active NPI

Seidy Idalis Delgado Pons, M.D.

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1093827644
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1319 Issued in FL
Practice address
3372 W Southport Rd
Kissimmee, FL 34746-2706
Phone
(407) 933-7900
Fax
(321) 437-0072
NPI assigned
Aug 31, 2006
Last updated
May 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16135 PR
General Practice Physician 208D00000X ACN1319 FL Primary

Addresses

Primary practice location

3372 W Southport Rd
Kissimmee, FL 34746-2706

Mailing address

6675 Westwood Blvd Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330

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
I20210506002802 FL Practitioner - General Practice 3577562016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Home Alliance, LLCGroup PAC ID 6406096536, 60 clinicians

Practice addresses (Care Compare)

3372 W Southport Rd
Kissimmee, FL 34746-2706
Phone (407) 933-7900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN1319FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Home Alliance LLC CurrentSince Jan 20, 2021 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients

Locations

3372 W Southport Rd
Kissimmee, FL 34746
Phone (407) 933-7900

3372 W Southport Rd
Ste A
Kissimmee, FL 34746

6675 Westwood Blvd
Ste 475
Orlando, FL 32821
Phone (407) 845-0384

4543 Pleasant Hill Rd
Spc A
Poinciana, FL 34759
Phone (407) 223-4379

199 Avenue K SE
Winter Haven, FL 33880
Phone (563) 588-1424

Networks

  • Freedom Health HMO Network

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, 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1093827644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216027",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3372 W SOUTHPORT RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462706",
            "telephone_number": "407-933-7900",
            "fax_number": "321-437-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO PONS",
        "first_name": "SEIDY",
        "middle_name": "IDALIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16135",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.