Individual provider Active NPI

Sijo Joseph Parekattil, MD

  • Urology Physician
  • Winter Garden, FL
National Provider Identifier
1417908013
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME92021 Issued in FL
Practice address
15548 W Colonial Dr
Winter Garden, FL 34787-9556
Phone
(407) 547-1654
Fax
(407) 650-2724
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME92021 FL Primary

Addresses

Primary practice location

15548 W Colonial Dr
Winter Garden, FL 34787-9556

Mailing address

2341 Golden Aster St
Clermont, FL 34711-6359
Phone (863) 258-4999

Other identifiers 2

IdentifierTypeStateIssuer
ME92021OtherFLMEDICAL LICENSE
272132500MedicaidFL

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
I20050712000627 FL Practitioner - Urology 3971539834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
New York Medical College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15548 W Colonial Dr
Winter Garden, FL 34787-9556
Phone (407) 547-1654

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME92021FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2020 Accepting new patients
Avant Concierge Urology, LLC CurrentSince Oct 1, 2021 Accepting new patients
Orlando Health Medical Group Inc Urology CurrentSince Sep 1, 2020 Accepting new patients
Quiescence Anesthesia LLC CurrentSince Oct 1, 2021 Accepting new patients
Orlando Health Network Inc Past Accepting new patients

Locations

2080 Oakley Seaver Dr
Clermont, FL 34711
Phone (352) 241-7275

1920 Don Wickham Dr
Clermont, FL 34711
Phone (352) 243-5891

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

15548 W Colonial Dr
Winter Garden, FL 34787
Phone (407) 547-1654

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 5

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 5

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1417908013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 GOLDEN ASTER ST",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116359",
            "telephone_number": "863-258-4999",
            "fax_number": "407-650-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15548 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347879556",
            "telephone_number": "407-547-1654",
            "fax_number": "407-650-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAREKATTIL",
        "first_name": "SIJO",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME92021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME92021",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272132500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.