Jimmy Bill Servetas, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS11391 Issued in FL

Practice address

653 Canter CT
Avon Lake, OH 44012-4026

Phone

(440) 930-5850

NPI assigned

Jul 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Coral Springs, FL
  • NPI 1871542969

  Emergency Medicine, FL

  Medicare reassignment Care Compare group NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180

  Emergency Medicine, FL

  Medicare reassignment NPD
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459

  Emergency Medicine, FL

  Medicare reassignment NPD
• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Deerfield Beach, FL
  • NPI 1407805591

  Emergency Medicine

  NPD
• ER-Doc Inc

  • Emergency Medicine Physician
  • Sandusky, OH
  • NPI 1922092014

  Emergency Medicine

  NPD (past)
• FL-I Medical Services, LLC

  • Physician Assistant
  • Margate, FL
  • NPI 1780959643
  NPD (past)

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

• North Broward Hospital District

  • General Acute Care Hospital
  • Coral Springs, FL
  • NPI 1174551147

  Hospital

  Care Compare affiliation

Specialty

Emergency Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Emergency Medicine of Broward LLC 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Broward Health Coral Springs Hospital, Coral Springs, FL, CCN 100276

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1306045265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 CANTER COURT",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "44012",
            "telephone_number": "440-930-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 CANTER CT",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124026",
            "telephone_number": "440-930-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVETAS",
        "first_name": "JIMMY",
        "middle_name": "BILL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS11391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Salsbury, M.A. CCC-SLP
• Amanda Scherach
• Lindsey Ann Schnell, OT
• Morgan Elizabeth Scott, PA-C
• Scott H. Seipel, OD
• Karan Sandip Shah, PT, DPT
• Aarika Sheehan, PT, DPT
• Jaclyn Shlapack, LPCC
• Melanie J Shmois, MSSA
• Michael Shockey

• All providers in Avon Lake, OH
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.