Individual provider Active NPI

Jennifer Kristin Logan, M.D.

  • Radiation Oncology Physician
  • Orlando, FL
National Provider Identifier
1184043903
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME140382 Issued in FL
Practice address
1400 S Orange Ave
Orlando, FL 32806-2134
Phone
(321) 841-8650
Fax
(321) 841-3794
NPI assigned
Apr 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME140382 FL Primary

Addresses

Primary practice location

1400 S Orange Ave
Orlando, FL 32806-2134

Mailing address

1400 S Orange Ave
Orlando, FL 32806-2134
Phone (321) 841-8650

Other identifiers 1

IdentifierTypeStateIssuer
102640400MedicaidFL

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
I20190429001295 FL Practitioner - Radiation Oncology 5698017358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Tufts University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1400 S Orange Ave
Orlando, FL 32806-2134
Phone (321) 841-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME140382FLMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jun 1, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jun 1, 2019 Accepting new patients

Locations

210 Rinehart Rd
Lake Mary, FL 32746
Phone (321) 841-1869

9900 W Colonial Dr
Ocoee, FL 34761
Phone (321) 841-6308

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1400 S Orange Ave
Orlando, FL 32806
Phone (321) 841-1893

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jlogan27303@orlandohealth.medalliesdirect.net

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.

Hospital & facility affiliations 4

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1184043903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062134",
            "telephone_number": "321-841-8650",
            "fax_number": "321-841-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062134",
            "telephone_number": "321-841-8650",
            "fax_number": "321-841-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "JENNIFER",
        "middle_name": "KRISTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME140382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102640400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.