Clermont Internal and Cosmetic Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CLERMONT INTERNAL AND COSMETIC MEDICINE LLC

Practice address

290 Citrus Tower Blvd
Suite 102
Clermont, FL 34711-2783

Phone

(352) 404-5174

Fax

(352) 678-3430

NPI assigned

Apr 7, 2015

Organization subpart

No

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

Authorized official

Name

Edriss Estime, MDNPI 1720272859

Title

Owner/Authorized Rep

Phone

(352) 404-5174

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FHACDA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edriss Estime, M.D.

  • Internal Medicine Physician
  • Clermont, FL
  • NPI 1720272859
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1437545472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CITRUS TOWER BLVD",
            "address_2": "SUITE 102",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112783",
            "telephone_number": "352-404-5174",
            "fax_number": "352-678-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CITRUS TOWER BLVD",
            "address_2": "SUITE 102",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112783",
            "telephone_number": "352-404-5174",
            "fax_number": "352-678-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLERMONT INTERNAL AND COSMETIC MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-07",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "ESTIME",
        "authorized_official_first_name": "EDRISS",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED REP",
        "authorized_official_telephone_number": "352-404-5174",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014748100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Clermont, FL
• Providers in Clermont, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.