Individual provider Active NPI

Jordan Lupo Heath, M.D.

  • Allergy Physician
  • Gainesville, FL
National Provider Identifier
1114360930
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
ME149410 Issued in FL
Practice address
4343 Newberry Rd Ste 1
Gainesville, FL 32607-2822
Phone
(352) 331-3502
Fax
(352) 331-3488
NPI assigned
Apr 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X ME149410 FL Primary

Addresses

Primary practice location

4343 Newberry Rd Ste 1
Gainesville, FL 32607-2822

Mailing address

4881 NW 8TH Ave.
Suite 2
Gainesville, FL 32605-4582
Phone (352) 416-1082

Other identifiers 1

IdentifierTypeStateIssuer
111133800MedicaidFL

Other names 1

  • Jordan Elizabeth Lupo Former name

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
I20210730000053 FL Practitioner - Allergy/Immunology 1759678535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Arkansas College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simedhealth LLCGroup PAC ID 6608137054, 89 clinicians

Practice addresses (Care Compare)

4343 W Newberry Rd
Gainesville, FL 32607-2817
Phone (352) 416-1082

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as group
Quality
65.57
Promoting interoperability
99
Improvement activities
40
Cost
78.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME149410FLMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Simedhealth LLC Allergy CurrentSince Sep 7, 2021 Accepting new patients
Simed Health LLC CurrentSince Sep 7, 2021 Accepting new patients

Locations

1315 NW 21st Ave
Ste 4
Chiefland, FL 32626
Phone (352) 331-1000

4343 Newberry Rd
Gainesville, FL 32607
Phone (352) 224-2200

4881 NW 8th Ave
Ste 2
Gainesville, FL 32605
Phone (352) 373-6338

4343 Newberry Rd
Ste 1
Gainesville, FL 32607
Phone (352) 331-3502

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1114360930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 NW 8TH AVE.",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054582",
            "telephone_number": "352-416-1082",
            "fax_number": "352-373-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 NEWBERRY RD STE 1",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072822",
            "telephone_number": "352-331-3502",
            "fax_number": "352-331-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH",
        "first_name": "JORDAN",
        "middle_name": "LUPO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "FL",
            "license": "ME149410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111133800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "LUPO",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.