Nicole Jimenez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME165440 Issued in FL

Practice address

65 Riley Rd
Kissimmee, FL 34747-5419

Phone

(407) 635-3022

Fax

(321) 230-4669

NPI assigned

Apr 7, 2021

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Florida State University College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Hospital, Orlando, FL, CCN 100006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Orlando Physicians Network Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1568693554

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557

  Family Medicine

  Medicare reassignment NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319

  Family Medicine

  Medicare reassignment NPD
• The Christian & Missionary Alliance Foundation Inc

  dba Shell Point

  • General Practice Physician
  • Fort Myers, FL
  • NPI 1821160607
  Medicare reassignment NPD
• Lee Health System Inc

  dba Lee Health Specialty Pharmacy

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  dba LCH-Golisano Peds PC Bayshore

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Lee Memorial Health System

  dba LCH- Pediatric Ophthalmology

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1770165920
  NPD
• The Christian & Missionary Alliance Foundation Inc

  dba Shell Point Home Health

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1932766953
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  Care Compare affiliation

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1497334171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 RILEY RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347475419",
            "telephone_number": "407-635-3022",
            "fax_number": "321-230-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 RILEY RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347475419",
            "telephone_number": "407-635-3022",
            "fax_number": "321-230-4669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2780 Cleveland Ave Ste 709",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015857",
            "country_code": "US",
            "telephone_number": "239-343-2371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13880 Shell Point Plz Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083504",
            "country_code": "US",
            "telephone_number": "239-454-2044",
            "fax_number": "239-454-2279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME165440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120414400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leisa M Jimenez-Cordero
• Carla Jeannette Jimenez
• Daniella Carolina Jimenez, OTR/L
• Kenneth Jimenez, MD
• Mary Betsy Jimenez
• Rafael Jimenez, MD
• Wilmarie Ivette Jimenez
• Zoar Jimenez, PTA
• Jimmy Nguyen OD PA
• JJ Care Transportation

• Family Medicine Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.