Organization Active NPI

Cardiovascular Solutions Institute Outpatient Services, LLC

  • Cardiovascular Disease Physician
  • Bradenton, FL
National Provider Identifier
1487125035
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOVASCULAR SOLUTIONS INSTITUTE OUTPATIENT SERVICES, LLC
Practice address
2210 61St St W
Bradenton, FL 34209-5527
Phone
(941) 747-8789
NPI assigned
Dec 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Authorized official

Name
Gino J Sedillo, MDNPI 1982680179
Title
Owner
Phone
(941) 747-8789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

2210 61St St W
Bradenton, FL 34209-5527

Mailing address

2210 61St St W
Bradenton, FL 34209-5527
Phone (941) 747-8789

Other identifiers 1

IdentifierTypeStateIssuer
FJ639AOtherFLPROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191009001708 FL Part B Supplier - Clinic/Group Practice 9133450943 Receives reassigned benefits from 2 practitioners
Practice locations: Bradenton, FL

National Provider Directory

National Provider Directory

Locations

714 Manatee Ave E
Ste A
Bradenton, FL 34208
Phone (941) 747-8789

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1487125035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 61ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095527",
            "telephone_number": "941-747-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 61ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095527",
            "telephone_number": "941-747-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR SOLUTIONS INSTITUTE OUTPATIENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-07",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "SEDILLO",
        "authorized_official_first_name": "GINO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-747-8789",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "FJ639A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.