Active NPI
Gerardo De Jesus
- Pastoral Counselor
- Orlando, FL
National Provider Identifier
1245748276
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Oct 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- IMH5110
- Practice address
- 1400 N Semoran Blvd
Orlando, FL 32807-3536 - Phone
- (407) 405-7677
- NPI assigned
- Jan 11, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | IMH5110 | FL | Primary |
Addresses
Primary practice location
1400 N Semoran Blvd
Orlando, FL 32807-3536
Mailing address
2557 Runyon Cir
Orlando, FL 32837-5206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH5110 | FL | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515628800000",
"number": "1245748276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2557 RUNYON CIR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328375206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N SEMORAN BLVD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328073536",
"telephone_number": "407-405-7677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JESUS",
"first_name": "GERARDO",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-11",
"last_updated": "2018-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Pastoral",
"state": "FL",
"license": "IMH5110",
"primary": true
}
],
"identifiers": [],
"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 Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.