NPIMap

Organization Active NPI

Premier Medical Associates All Florida, LLC

Doing business as Premier Medical Associates

  • Internal Medicine Physician
  • The Villages, FL
National Provider Identifier
1093829442
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0069935 Issued in FL
Legal business name
PREMIER MEDICAL ASSOCIATES ALL FLORIDA, LLC
Doing business as
Premier Medical Associates
Practice address
1580 Santa Barbara Blvd
Suite C
The Villages, FL 32159
Phone
(352) 259-2159
Fax
(352) 259-5731
NPI assigned
Aug 19, 2006
Last updated
Nov 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Authorized official

Name
Cynthia Romska
Title
Credentialing Specialist
Phone
(352) 259-2159

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0069935 FL Primary
Nephrology Physician 207RN0300X ME95629 FL
Adult Health Nurse Practitioner 363LA2200X ARNP3378652 FL

Addresses

Primary practice location

1580 Santa Barbara Blvd
Suite C
The Villages, FL 32159

Mailing address

1580 Santa Barbara Blvd
The Villages, FL 32159-6827
Phone (352) 259-2159

Other identifiers 2

IdentifierTypeStateIssuer
004699000MedicaidFL
K3300OtherFLPTAN

Other names 1

  • Premier Medical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041026000956 FL Part B Supplier - Clinic/Group Practice 2365418019 Receives reassigned benefits from 104 practitioners
Practice locations: Leesburg, FL; The Villages, FL; Summerfield, FL; St Cloud, FL; Orlando, FL; Ocala, FL; Lady Lake, FL; Kissimmee, FL…

National Provider Directory

National Provider Directory

Locations

15701 State Road 50
Ste 106
Clermont, FL 34711

210 N US Highway 27
Clermont, FL 34711
Phone (352) 243-4800

40230 Highway 27
Davenport, FL 33837

13696 N US Highway 441
Lady Lake, FL 32159
Phone (352) 775-1221

1704 Citrus Blvd
Leesburg, FL 34748
Phone (352) 365-9553

17580 US Highway 441
Mount Dora, FL 32757
Phone (352) 357-1668

1277 N Semoran Blvd
Ste 102
Orlando, FL 32807

1501 N US Highway 441
#1600
The Villages, FL 32159

910 Old Camp Rd
Ste 196
The Villages, FL 32162
Phone (352) 565-5553

Practitioners & affiliated clinicians

Practitioners 121

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 121

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1093829442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159",
            "fax_number": "352-674-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "address_2": "SUITE C",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-259-2159",
            "fax_number": "352-259-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL ASSOCIATES ALL FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "ROMSKA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "352-259-2159"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0069935",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME95629",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP3378652",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004699000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "K3300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.