NPIMap

Individual provider Active NPI

Juan Pineda Lopez, M.D

  • General Practice Physician
  • Orlando, FL
National Provider Identifier
1104292846
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN683 Issued in FL
Practice address
5564 E Grant Street
Orlando, FL 32822-5301
Phone
(321) 235-6230
Fax
(321) 235-6246
NPI assigned
Aug 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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 ACN683 FL Primary
General Practice Physician 208D00000X 18959 PR

Addresses

Primary practice location

5564 E Grant Street
Orlando, FL 32822-5301

Mailing address

5564 E. Grant Street
Orlando, FL 32822-5301
Phone (321) 235-6230

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
I20170224001501 FL Practitioner - General Practice 7719295666 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Doctors Intrastate LLCGroup PAC ID 5395161186, 74 clinicians

Practice addresses (Care Compare)

729 Beville Rd
South Daytona, FL 32119-1823
Phone (386) 256-4791

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18959PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roy H Hinman MD PA CurrentSince Dec 2, 2024 Accepting new patients
Caremax Medical Centers of Central Florida LLC CurrentSince Jan 29, 2022 Accepting new patients
Island Doctors Intrastate LLC CurrentSince Dec 2, 2024 Accepting new patients
Caremax Medical Centers of Central Florida, LLC CurrentSince Jan 29, 2022 Accepting new patients
Lina L Feaster PA PastSince Jan 2, 2004 Accepting new patients

Locations

701 E State Road 50
Ste 731C
Clermont, FL 34711
Phone (321) 235-6230

1000 NW 57th Ct
Ste 400
Miami, FL 33126

905 S Dixie Fwy
New Smyrna Beach, FL 32168

5564 E Grant St
Orlando, FL 32822
Phone (321) 235-6230

729 Beville Rd
South Daytona, FL 32119
Phone (386) 256-4791

100 Arricola Ave
St Augustine, FL 32080
Phone (904) 825-4368

103 Anastasia Blvd
St Augustine, FL 32080
Phone (904) 825-4747

2460 Old Moultrie Rd
Ste 1
St Augustine, FL 32086
Phone (904) 293-0299

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: juan.pinedalopez.p1@direct.caremax.nextgenshare.com

Organizations & group practices 5

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 7

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": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1104292846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5564 E. GRANT STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328225301",
            "telephone_number": "321-235-6230",
            "fax_number": "321-235-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5564 E GRANT STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328225301",
            "telephone_number": "321-235-6230",
            "fax_number": "321-235-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEDA LOPEZ",
        "first_name": "JUAN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-17",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN683",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18959",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.