Individual provider Active NPI

Jay A Redan, MD

  • Surgery Physician
  • Celebration, FL
National Provider Identifier
1376562553
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME89458 Issued in FL
Practice address
400 Celebration PL
Suite a-140
Celebration, FL 34747-4970
Phone
(407) 303-4602
Fax
(407) 303-4603
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME89458 FL Primary

Addresses

Primary practice location

400 Celebration PL
Suite a-140
Celebration, FL 34747-4970

Mailing address

400 Celebration PL
Suite a-140
Celebration, FL 34747-4970
Phone (407) 303-4602

Other identifiers 3

IdentifierTypeStateIssuer
269094200MedicaidFL
37613OtherFLBCBS
P00149683OtherRAILROAD MEDICARE

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
I20040601001293 FL Practitioner - General Surgery 5193626703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rutgers New Jersey Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

400 Celebration PL
Suite A140
Celebration, FL 34747-4970
Phone (407) 303-4602

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Hernia repair - groin (open)14
Upper gastrointestinal (GI) endoscopy for acid reflux12
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME89458FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Apr 15, 2004 Accepting new patients
Florida Hospital Medical Group Inc Surgery CurrentSince Apr 15, 2004 Accepting new patients

Locations

400 Celebration Pl
Ste A140
Kissimmee, FL 34747
Phone (407) 303-4602

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jredan73743@adventhealth.direct-ci.com

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1376562553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL",
            "address_2": "SUITE A-140",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-303-4602",
            "fax_number": "407-303-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL",
            "address_2": "SUITE A-140",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-303-4602",
            "fax_number": "407-303-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDAN",
        "first_name": "JAY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME89458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269094200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37613",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00149683",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.