Theodosios Soldatos, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME68179 Issued in FL

Practice address

100 Commercial Dr
Keystone Heights, FL 32656-6802

Phone

(352) 473-6595

Fax

(352) 473-6597

NPI assigned

Feb 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theodosios.soldatos.p1@direct.azahealth.nextgenshare.com

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.

• Rural Health Care Incorporated

  dba Aza Health

  • Federally Qualified Health Center (FQHC)
  • Palatka, FL
  • NPI 1871569061

  Internal Medicine

  Medicare reassignment NPD
• Rural Health Care Incorporated

  dba Aza Health

  • Federally Qualified Health Center (FQHC)
  • Keystone Heights, FL
  • NPI 1073589065
  NPD
• Rural Health Care, Inc.

  dba Aza Health

  • Federally Qualified Health Center (FQHC)
  • Daytona Beach, FL
  • NPI 1891227179
  NPD

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

{
    "created_epoch": "1140220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1114992625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 RIVER ST",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321775042",
            "telephone_number": "386-328-8371",
            "fax_number": "386-328-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COMMERCIAL DR",
            "city": "KEYSTONE HEIGHTS",
            "state": "FL",
            "postal_code": "326566802",
            "telephone_number": "352-473-6595",
            "fax_number": "352-473-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLDATOS",
        "first_name": "THEODOSIOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-18",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME68179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377896700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd David Shockley, D.M.D.
• Nancy I. Short, D.C.
• Jennifer L Siegel, ARNP
• Mary Liza Skinner
• Sleep Medicine Center Inc
• Sidney Srivibul
• Angela Stanley, PT
• Starke Family Medical Center Inc (Village Doctors)
• Starke Family Medical Center Inc (Village Doctors)
• Jinnifer Melissa Stephan, D.C.

• Internal Medicine Physician in Keystone Heights, FL
• Providers in Keystone Heights, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.