Individual provider Active NPI

Jose Manuel Fernandez-Semidey, MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Temple Terrace, FL
National Provider Identifier
1295900819
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
ME105393 Issued in FL
Practice address
12470 Telecom Dr
Suite 300W
Temple Terrace, FL 33637-0904
Phone
(863) 287-6569
Fax
(863) 968-1797
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X ME105393 FL Primary

Addresses

Primary practice location

12470 Telecom Dr
Suite 300W
Temple Terrace, FL 33637-0904

Mailing address

12470 Telecom Dr
Suite 300W
Temple Terrace, FL 33637-0904
Phone (863) 287-6569

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
I20100121000357 FL Practitioner - Family PracticePractitioner - Other (Physician) 8921170473 Reassigns benefits to 1 organization

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Good Shepherd Hospice, Inc. Hospice and Palliative Medicine CurrentSince Oct 1, 2013 Accepting new patients
Good Shepherd Hospice, Inc. Hospice and Palliative Medicine CurrentSince Oct 1, 2013 Accepting new patients

Locations

450 Arneson Ave
Auburndale, FL 33823
Phone (863) 297-1880

1110 Hammock Rd
Sebring, FL 33870
Phone (863) 402-1066

12470 Telecom Dr
Ste 300
Temple Terrace, FL 33637
Phone (813) 871-8111

12470 Telecom Dr
Ste 300W
Temple Terrace, FL 33637
Phone (813) 871-8183

12470 Telecom Dr
Ste 301
Temple Terrace, FL 33637
Phone (423) 707-8678

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.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1295900819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR",
            "address_2": "SUITE 300W",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "863-287-6569",
            "fax_number": "863-968-1797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR",
            "address_2": "SUITE 300W",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "863-287-6569",
            "fax_number": "863-968-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ-SEMIDEY",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME105393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.