Individual provider Active NPI

Andrea Jade Alvarez, D.O.

  • Emergency Medicine Physician
  • Key West, FL
National Provider Identifier
1104262872
Registry record updated Dec 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS12345 Issued in FL
Practice address
57 Palmetto Dr
Key West, FL 33040-5641
Phone
(305) 915-0529
Fax
(305) 701-4533
NPI assigned
May 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS12345 FL Primary

Addresses

Primary practice location

57 Palmetto Dr
Key West, FL 33040-5641

Mailing address

57 Palmetto Dr
Key West, FL 33040-5641
Phone (305) 915-0529

Other practice location 1

8201 W Broward Blvd
Dept of Emergency Medicine
Plantation, FL 33324-2701
Phone (954) 476-3900

Other identifiers 1

IdentifierTypeStateIssuer
012364800MedicaidFL

Other names 1

  • Andrea Jade Betancourt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141029002271 FL Practitioner - Emergency Medicine 2567683899 Reassigns benefits to 5 organizations
I20260415003149 LA Practitioner - Emergency Medicine 2567683899 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS12345FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Md4Er LLC CurrentSince Feb 2, 2019 Accepting new patients
Em Alliance LLC Emergency Medicine CurrentSince Jun 1, 2025 Accepting new patients
Shi Keys LLC Emergency Medicine CurrentSince Oct 1, 2023 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients

Locations

5506 14th St W
Bradenton, FL 34207
Phone (941) 745-7372

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

5900 W Junior College Rd
Key West, FL 33040
Phone (305) 294-5531

3301 Overseas Hwy
Marathon, FL 33050
Phone (305) 743-5533

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

91500 Overseas Hwy
Tavernier, FL 33070
Phone (305) 434-3000

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

7 Easton Oval
#L4387
Columbus, OH 43219

Organizations & group practices 6

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 20

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

View all 20

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of FL LLC 686 clinicians
River Oaks Emergency Group, LLC 33 clinicians
Paragon Emergency Services LLC 401 clinicians

Practice addresses (Care Compare)

325 Cypress Pkwy
Kissimmee, FL 34759-3326
Phone (407) 530-2000

3330 Masonic Dr
Alexandria, LA 71301-3841
Phone (318) 487-1122

3625 University Blvd S
Jacksonville, FL 32216-4207
Phone (904) 702-6111

Hospital & facility affiliations

  • Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035
  • Christus St Frances Cabrini Hospital Hospital, Alexandria, LA, CCN 190019
  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733616000000",
    "number": "1104262872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 PALMETTO DR",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330405641",
            "telephone_number": "305-915-0529",
            "fax_number": "305-701-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PALMETTO DR",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330405641",
            "telephone_number": "305-915-0529",
            "fax_number": "305-701-4533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8201 W Broward Blvd",
            "address_2": "Dept of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333242701",
            "country_code": "US",
            "telephone_number": "954-476-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "ANDREA",
        "middle_name": "JADE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2024-12-08",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS12345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012364800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BETANCOURT",
            "middle_name": "JADE",
            "credential": "D.O",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Key West, FL

Sources for this page

Verify at the official NPI Registry.