Individual provider Active NPI

Luis Eduardo Llerena, M.D.

  • Trauma Surgery Physician
  • Sarasota, FL
National Provider Identifier
1487611901
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
ME85050 Issued in FL
Practice address
1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone
(941) 262-1200
Fax
(941) 262-3710
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X ME85050 FL Primary

Addresses

Primary practice location

1700 S Tamiami TRL
Sarasota, FL 34239-3509

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Other practice location 1

14100 Fivay Rd
Suite 280
Hudson, FL 34667-7180
Phone (727) 862-6524

Other practice location 2

1921 Waldemere St
Sarasota, FL 34239-2943
Phone (412) 621-2009

Other identifiers 2

IdentifierTypeStateIssuer
104546000MedicaidFL
264771100MedicaidFL

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
I20080724000373 FL Practitioner - General SurgeryPractitioner - General PracticePractitioner - Critical Care (Intensivists) 9931199767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
University of Maryland School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc CurrentSince Jul 8, 2023 Accepting new patients
Wellspan Medical Group Past Accepting new patients
SMH Physician Services Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1921 Waldemere St
Sarasota, FL 34239
Phone (941) 914-2600

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

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 1

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1487611901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S TAMIAMI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393509",
            "telephone_number": "941-262-1200",
            "fax_number": "941-262-3710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14100 Fivay Rd",
            "address_2": "Suite 280",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "FL",
            "postal_code": "346677180",
            "country_code": "US",
            "telephone_number": "727-862-6524",
            "fax_number": "727-862-6439",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1921 Waldemere St",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342392943",
            "country_code": "US",
            "telephone_number": "412-621-2009",
            "fax_number": "941-262-3710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LLERENA",
        "first_name": "LUIS",
        "middle_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "ME85050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104546000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264771100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.