Active NPI
Metcare of Orange City
- Family Medicine Physician
- Orange City, FL
National Provider Identifier
1295110203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- METCARE OF ORANGE CITY
- Practice address
- 2669 Enterprise Rd
Orange City, FL 32763-8217 - Phone
- (386) 774-0491
- Fax
- (386) 774-7160
- NPI assigned
- Jul 21, 2015
- Organization subpart
- Yes
- Parent organization
- METROPOLITAN HEALTH NETWORKS, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jessica Marie Bonetti
- Title
- Associate Director
- Phone
- (305) 500-2000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2669 Enterprise Rd
Orange City, FL 32763-8217
Mailing address
6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CX415B | Other | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100308000361 | FL | Part B Supplier - Clinic/Group Practice | 9739265141 |
Receives reassigned benefits from 61 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wellington, FL; Stuart, FL; Royal Palm Beach, FL; Fort Pierce, FL; Port St Lucie, FL; Port Saint Lucie, FL; Okeechobee, FL; Lake Park, FL… |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Albert Zamek
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Infectious Disease Physician
- Ormond Beach, FL
- NPI 1295859924
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437436800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724025600000",
"number": "1295110203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6101 BLUE LAGOON DR STE 200",
"city": "MIAMI",
"state": "FL",
"postal_code": "331263168",
"telephone_number": "305-500-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2669 ENTERPRISE RD",
"city": "ORANGE CITY",
"state": "FL",
"postal_code": "327638217",
"telephone_number": "386-774-0491",
"fax_number": "386-774-7160"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "METCARE OF ORANGE CITY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "METROPOLITAN HEALTH NETWORKS, INC",
"enumeration_date": "2015-07-21",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A",
"authorized_official_last_name": "BONETTI",
"authorized_official_first_name": "JESSICA",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
"authorized_official_telephone_number": "305-500-2000"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "CX415B",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.