NPIMap

Organization Active NPI

Celebration Orthopedic and Sports Medicine Institute Inc

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Kissimmee, FL
National Provider Identifier
1285595660
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
CELEBRATION ORTHOPEDIC AND SPORTS MEDICINE INSTITUTE INC
Practice address
339 Cypress Pkwy Ste 220
Kissimmee, FL 34759-3315
Phone
(321) 939-0222
NPI assigned
Nov 24, 2025
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Tina McKenna
Title
Billing Manager
Phone
(321) 939-0222

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20260406000565 FL DME Supplier - Physician - Family PracticeDME Supplier - Sports Medicine 6901851013 Practice locations: Kissimmee, FL

National Provider Directory

National Provider Directory
Tax ID family
Celebration Orthopedic and Sports Medicine Institute Inc (3 organizations share this tax ID)

Locations

2954 Mallory Cir
Ste 101
Kissimmee, FL 34747
Phone 3219390222120

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X Primary

Addresses

NPPES NPI Registry

Primary practice location

339 Cypress Pkwy Ste 220
Kissimmee, FL 34759-3315

Mailing address

2954 Mallory Cir Ste 101
Celebration, FL 34747-1822

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
129001800MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 31, 2026.

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1285595660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2954 MALLORY CIR STE 101",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347471822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 CYPRESS PKWY STE 220",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593315",
            "telephone_number": "321-939-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELEBRATION ORTHOPEDIC AND SPORTS MEDICINE INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-24",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "321-939-0222"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129001800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.