Individual provider Active NPI

George Michael Hudson, D.O.

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1124008388
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS5964 Issued in FL
Practice address
1537 S Alafaya TRL Ste 104
Orlando, FL 32828-8955
Phone
(407) 203-3888
Fax
(321) 235-0971
NPI assigned
Jan 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS5964 FL Primary

Addresses

Primary practice location

1537 S Alafaya TRL Ste 104
Orlando, FL 32828-8955

Mailing address

1537 S Alafaya TRL
Orlando, FL 32828-8957
Phone (407) 203-3888

Other identifiers 1

IdentifierTypeStateIssuer
1124008388MedicaidFL

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
I20070726000587 FL Practitioner - Family Practice 7517068117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1537 S Alafaya TRL
Suite 104
Orlando, FL 32828-8955
Phone (407) 203-3888

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Orlando, FL, CCN 107234
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avalon Park Family Medicine Family Medicine Current Accepting new patients
Waterford Park Family Medicine Family Medicine Past Accepting new patients
East Orlando Family Medicine Associates PA Family Medicine Past Accepting new patients
Richard S Bragg MD PA Past Accepting new patients

Locations

13000 Avalon Lake Dr
Ste 100
Orlando, FL 32828
Phone (321) 235-0970

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 3

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": "1137801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1124008388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1537 S ALAFAYA TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288957",
            "telephone_number": "407-203-3888",
            "fax_number": "321-235-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 S ALAFAYA TRL STE 104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288955",
            "telephone_number": "407-203-3888",
            "fax_number": "321-235-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "GEORGE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-21",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124008388",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.