Irissa Wilson Rosario, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME120306 Issued in FL

Practice address

51 Pennsylvania St
Orlando, FL 32806-2937

Phone

(321) 843-3220

Fax

(321) 843-3210

NPI assigned

Jun 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Irissa N. Wilson Former name

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)

Enrolled

Credentials

Doctor of Medicine

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.

• Pediatrix Medical Group of Florida Inc

  • Pediatric Cardiology Physician
  • Sunrise, FL
  • NPI 1083711790

  FL, Hospitalist

  Medicare reassignment NPD
• New Interlachen Pediatrics, P.a.

  • Pediatrics Physician
  • Maitland, FL
  • NPI 1659380459

  Pediatrics

  NPD (past)
• Thomas a Fisk MD

  • Non-Pharmacy Dispensing Site
  • Maitland, FL
  • NPI 1376589481
  NPD (past)

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1306130786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 PENNSYLVANIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062937",
            "telephone_number": "321-843-3220",
            "fax_number": "321-843-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 PENNSYLVANIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062937",
            "telephone_number": "321-843-3220",
            "fax_number": "321-843-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "IRISSA",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME120306",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME120306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012775500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRISSA",
            "last_name": "WILSON",
            "middle_name": "N.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Rosario
• Emmanuel Rosario
• Eva Maria Rosario
• Harry William Rosario
• Irene Rosario, MNT
• Javier Antonio Rosario, M.D.
• Javier Esteban Rosario, LCSW
• Jennifer Rosario, LMHC
• Jessica Rosario, M.D.
• Keyla M Rosario

• All providers in Orlando, FL
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.