Individual provider Active NPI

Debra Feliciano Padin, MD

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1205427093
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1613 Issued in FL
Practice address
309 W Bass St
Kissimmee, FL 34741-5011
Phone
(407) 935-1192
NPI assigned
Feb 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN1613 FL Primary
General Practice Physician 208D00000X 23608 PR

Addresses

Primary practice location

309 W Bass St
Kissimmee, FL 34741-5011

Mailing address

815 Woodbury Rd Ste 104
Orlando, FL 32828-4515
Phone (407) 282-3344

Other practice location 1

410 Ave Hostos Ste 2
Mayaguez, PR 00682-1500
Phone (787) 652-9200

Other practice location 2

815 Woodbury Rd Ste 104
Orlando, FL 32828-4515
Phone (407) 282-3344

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
I20241004001190 FL Practitioner - General Practice 3274078506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Sports and Family Health Center PAGroup PAC ID 0840236907, 8 clinicians

Practice addresses (Care Compare)

309 W Bass St
Kissimmee, FL 34741-5011
Phone (407) 935-1192

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN1613FLMDGeneral Practice Physician
23608PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Sports and Family Health Center PA CurrentSince Aug 25, 2024 Accepting new patients

Locations

309 W Bass St
Kissimmee, FL 34741
Phone (407) 935-1192

815 Woodbury Rd
Ste 104
Orlando, FL 32828
Phone (407) 282-3344

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1205427093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 WOODBURY RD STE 104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284515",
            "telephone_number": "407-282-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W BASS ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415011",
            "telephone_number": "407-935-1192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Ave Hostos Ste 2",
            "address_purpose": "LOCATION",
            "city": "Mayaguez",
            "state": "PR",
            "postal_code": "006821500",
            "country_code": "US",
            "telephone_number": "787-652-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "815 Woodbury Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328284515",
            "country_code": "US",
            "telephone_number": "407-282-3344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELICIANO PADIN",
        "first_name": "DEBRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1613",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23608",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.