Jose M Nieto, DO

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

OS10072 Issued in FL

Practice address

4200 Sun N Lake Blvd
Sebring, FL 33872-1986

Phone

(863) 402-3103

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Specialty

GastroenterologyAlso: Internal Medicine

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Digestive Disease ConsultantsGroup PAC ID 1850515040, 18 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Digestive Disease Consultants

  • Gastroenterology Physician
  • Jacksonville, FL
  • NPI 1710251921
  Medicare reassignment Care Compare group NPD
• Adventist Health System-Sunbelt Inc

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Medicare reassignment NPD
• Adventist Health System-Sunbelt Inc

  • Family Medicine Physician
  • Wauchula, FL
  • NPI 1578725941
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment NPD
• Hospital Authority of Valdosta and Lowndes County Georgia

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1306896253
  Medicare reassignment NPD
• South Georgia Medical Center Inc

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Medicare reassignment NPD
• Adventist Health System-Sunbelt Inc

  • Internal Medicine Physician
  • Sebring, FL
  • NPI 1164698809

  Gastroenterology

  NPD
• University of Florida Jacksonville Physicians Inc

  • Gastroenterology Physician
  • Jacksonville, FL
  • NPI 1730349002
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• Hospital Authority of Valdosta and Lowndes County Georgia

  • Psychiatric Hospital Unit
  • Valdosta, GA
  • NPI 1033160791
  NPD
• Hospital Authority of Valdosta and Lowndes County, Georgia

  • Ambulance
  • Valdosta, GA
  • NPI 1558141671
  NPD
• South Georgia Medical Center Inc

  • Critical Access Hospital
  • Lakeland, GA
  • NPI 1215703632
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1225190002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "863-402-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "863-402-3103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Belfort Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322566004",
            "country_code": "US",
            "telephone_number": "904-398-7205",
            "fax_number": "904-396-4047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIETO",
        "first_name": "JOSE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "20A8097",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "OS10072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279200100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "16365",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mike Lynn Nickless, CRNA
• Gloria M Nieves, OTR/L
• Charlene Ann Nikolakakis
• Jennifer L Noble
• Ali Noor, MD
• Northland Hearing Centers, Inc.

• Gastroenterology Physician in Sebring, FL
• Providers in Sebring, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.

Verify at the official NPI Registry.