Active NPI
Dominique Broutin, MD
- Endocrinology, Diabetes & Metabolism Physician
- Orlando, FL
National Provider Identifier
1194228924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- ME163046
- Practice address
- 3113 Lawton Rd Ste 100
Orlando, FL 32803-3519 - Phone
- (407) 894-3241
- Fax
- (407) 896-9863
- NPI assigned
- Mar 18, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | ME163046 | FL | Primary |
| Student Health Clinic/Center | 261QS1000X |
Addresses
Primary practice location
3113 Lawton Rd Ste 100
Orlando, FL 32803-3519
Mailing address
3113 Lawton Rd Ste 100
Orlando, FL 32803-3519
Phone (407) 894-3241
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118632800 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Endocrinology
- Education
- University of Florida College of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3113 Lawton Rd
Suite 100
Orlando, FL 32803-3519
Phone (321) 841-0000
Hospital & facility affiliations
- Orlando Health
- Adventhealth Orlando
- Orlando Health St Cloud Hospital
- Orlando Health-Health Central Hospital
- Orlando Health South Lake Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.91 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| ME163046 | FL | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health Medical Group Inc | Current | Accepting new patients | |
| Orlando Health Medical Group Inc | Current | Accepting new patients |
Locations
32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820
3113 Lawton Rd
Ste 100
Orlando, FL 32803
Phone (407) 894-3241
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- dominique.broutin@hca4.eclinicaldirectplus.com
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.
-
- Internal Medicine Physician
- Orlando, FL
- NPI 1669429577
-
- Durable Medical Equipment & Medical Supplies
- Winter Park, FL
- NPI 1265019541
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
-
- General Acute Care Hospital
- Ocoee, FL
- NPI 1033475959
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
-
- General Acute Care Hospital
- Saint Cloud, FL
- NPI 1164478442
-
- General Acute Care Hospital
- Clermont, FL
- NPI 1336221019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1194228924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3113 LAWTON RD STE 100",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328033519",
"telephone_number": "407-894-3241",
"fax_number": "407-896-9863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3113 LAWTON RD STE 100",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328033519",
"telephone_number": "407-894-3241",
"fax_number": "407-896-9863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUTIN",
"first_name": "DOMINIQUE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-18",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "FL",
"license": "ME163046",
"primary": true
},
{
"code": "261QS1000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Student Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "118632800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.