Individual provider Active NPI

Gregory A Deramo, ARNP

  • Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1134196702
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3172462 Issued in FL
Practice address
5655 S Orange Ave
Orlando, FL 32809-4289
Phone
(407) 895-4100
Fax
(407) 438-1543
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3172462 FL Primary

Addresses

Primary practice location

5655 S Orange Ave
Orlando, FL 32809-4289

Mailing address

5655 S Orange Ave
Orlando, FL 32809-4289
Phone (407) 895-4100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804000185 FL Practitioner - Nurse Practitioner 1254360852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3172462FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Medicine Inc CurrentSince Jul 1, 2017 Accepting new patients
Advanced Physical Medicine Inc CurrentSince Jul 1, 2017 Accepting new patients
Orlando Health Inc Past Accepting new patients

Locations

953 N Semoran Blvd
Orlando, FL 32807
Phone (407) 282-3615

12554 S John Young Pkwy
Ste 103
Orlando, FL 32837
Phone (407) 282-3615

Organizations & group practices 3

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1134196702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5655 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328094289",
            "telephone_number": "407-895-4100",
            "fax_number": "407-438-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328094289",
            "telephone_number": "407-895-4100",
            "fax_number": "407-438-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAMO",
        "first_name": "GREGORY",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "3172462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.