NPIMap

Individual provider Active NPI

Jose S Serrano, M.D.

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1386669778
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN635 Issued in FL
Practice address
308 W Bass St
Kissimmee, FL 34741-5001
Phone
(407) 933-1760
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN635 FL Primary

Addresses

Primary practice location

308 W Bass St
Kissimmee, FL 34741-5001

Mailing address

308 W Bass St
Kissimmee, FL 34741-5001
Phone (407) 933-1760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713000737 FL Practitioner - General Practice 3375724040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Healthcare Associates, IncGroup PAC ID 4183606601, 16 clinicians

Practice addresses (Care Compare)

308 W Bass St
Kissimmee, FL 34741-5001
Phone (407) 933-1760

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN635FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Healthcare Associates, Inc CurrentSince Jun 8, 2015 Accepting new patients
Policlinica de Familia Factor Inc Past Accepting new patients

Locations

308 W Bass St
Kissimmee, FL 34741
Phone (407) 483-8801

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 6

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1386669778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 W BASS ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415001",
            "telephone_number": "407-933-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W BASS ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415001",
            "telephone_number": "407-933-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "JOSE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.