Organization Active NPI

Careconnectmd Tennessee PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Memphis, TN
National Provider Identifier
1235857681
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
CARECONNECTMD TENNESSEE PC
Practice address
6000 Poplar Ave Ste 250
Memphis, TN 38119-3974
Phone
(888) 789-9585
Fax
(562) 803-4500
NPI assigned
Aug 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Authorized official

Name
Dr. Orlando Acosta Collado, MD
Title
Owner
Phone
(888) 789-9585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

6000 Poplar Ave Ste 250
Memphis, TN 38119-3974

Mailing address

3090 Bristol St Ste 200
Costa Mesa, CA 92626-3061
Phone (888) 789-9585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230329001222 TN Part B Supplier - Clinic/Group Practice 9436523644 Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1235857681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 BRISTOL ST STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263061",
            "telephone_number": "888-789-9585",
            "fax_number": "562-803-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 POPLAR AVE STE 250",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193974",
            "telephone_number": "888-789-9585",
            "fax_number": "562-803-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECONNECTMD TENNESSEE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "COLLADO",
        "authorized_official_first_name": "ORLANDO",
        "authorized_official_middle_name": "ACOSTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-789-9585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.