Individual provider Active NPI

Jeremy Richard John, MD, MPH

  • Surgery Physician
  • Celebration, FL
National Provider Identifier
1285078436
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME142761 Issued in FL
Practice address
380 Celebration PL FL 2
Celebration, FL 34747-4606
Phone
(407) 303-4760
Fax
(407) 303-4546
NPI assigned
Apr 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 079673 GA
Surgery Physician 208600000X ME142761 FL Primary

Addresses

Primary practice location

380 Celebration PL FL 2
Celebration, FL 34747-4606

Mailing address

380 Celebration PL FL 2
Celebration, FL 34747-4606
Phone (407) 303-4760

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
I20191211000811 FL Practitioner - General Surgery 1052663614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Emory University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

380 Celebration PL
FL 2
Celebration, FL 34747-4606
Phone (407) 303-4760

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy31
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Dec 2, 2019 Accepting new patients
Florida Hospital Medical Group Inc Surgery CurrentSince Dec 2, 2019 Accepting new patients

Locations

380 Celebration Pl
Fl 2
Kissimmee, FL 34747
Phone (407) 303-4190

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jjohn73763@adventhealth.direct-ci.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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1285078436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CELEBRATION PL FL 2",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474606",
            "telephone_number": "407-303-4760",
            "fax_number": "407-303-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CELEBRATION PL FL 2",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474606",
            "telephone_number": "407-303-4760",
            "fax_number": "407-303-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "JEREMY",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-18",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "GA",
            "license": "079673",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME142761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.