Individual provider Active NPI

William Joel Rivera Carrero, MD

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1104669506
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1783 Issued in FL
Practice address
1210 E Osceola Pkwy Ste 201
Kissimmee, FL 34744-1621
Phone
(321) 422-2303
Fax
(855) 538-4617
NPI assigned
Jun 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X ACN1783 FL Primary

Addresses

Primary practice location

1210 E Osceola Pkwy Ste 201
Kissimmee, FL 34744-1621

Mailing address

1210 E Osceola Pkwy Ste 201
Kissimmee, FL 34744-1621
Phone (321) 422-2303

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
I20260527003922 FL Practitioner - General Practice 0840760187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1327 Winter Garden Vineland Rd
Winter Garden, FL 34787-4363

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN1783FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth Clinical Inc. Single Specialty PastSince Nov 19, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEGCCD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1104669506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 E OSCEOLA PKWY STE 201",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441621",
            "telephone_number": "321-422-2303",
            "fax_number": "855-538-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 E OSCEOLA PKWY STE 201",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441621",
            "telephone_number": "321-422-2303",
            "fax_number": "855-538-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA CARRERO",
        "first_name": "WILLIAM",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-14",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.