NPIMap

Individual provider Active NPI

Luis S Ulloa, M.D.

  • Internal Medicine Physician
  • Jupiter, FL
National Provider Identifier
1457318636
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME38283 Issued in FL
Practice address
601 University Blvd
Suite 202
Jupiter, FL 33458-2788
Phone
(561) 627-7766
Fax
(561) 691-4865
NPI assigned
Apr 30, 2006
Last updated
Aug 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME38283 FL Primary

Addresses

Primary practice location

601 University Blvd
Suite 202
Jupiter, FL 33458-2788

Mailing address

1094 Military TRL
Jupiter, FL 33458-7021
Phone (561) 622-6111

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
I20070410000716 FL Practitioner - Internal MedicinePractitioner - General Practice 3779688338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hernando Pasco Primary Care LLCGroup PAC ID 0547231474, 88 clinicians

Practice addresses (Care Compare)

1094 Military TRL
Jupiter, FL 33458-7021
Phone (561) 622-6111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME38283FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hernando Pasco Primary Care LLC Internal Medicine CurrentSince Mar 1, 2022 Accepting new patients
The Medical Group of South Florida, Inc Past Accepting new patients
Adult Medicine Center of South Florida PA Past Accepting new patients
Luis S. Ulloa Mdpa Internal Medicine Past Accepting new patients
Adult Medicine Specialists, PLLC Internal Medicine PastSince Oct 17, 2006 Accepting new patients
The Medical Group of South Florida Inc PastSince Oct 17, 2021 Accepting new patients
Independant Ipa,LLC Past Accepting new patients

Locations

11373 Cortez Blvd
Ste 206
Brooksville, FL 34613
Phone (352) 596-3032

3465 Galt Ocean Dr
Ste 101
Ft Lauderdale, FL 33308
Phone (954) 566-7775

1094 Military Trl
Jupiter, FL 33458
Phone (561) 622-6111

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CIDHCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIBHCD
  • Direct secure messaging: lulloa21030@jupitermedicalcenter.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1146355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1457318636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1094 MILITARY TRL",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587021",
            "telephone_number": "561-622-6111",
            "fax_number": "855-215-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 UNIVERSITY BLVD",
            "address_2": "SUITE 202",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582788",
            "telephone_number": "561-627-7766",
            "fax_number": "561-691-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLOA",
        "first_name": "LUIS",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-30",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME38283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.