Individual provider Active NPI

Edgar Ivon Cardenas Gomez, MD

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1508050048
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME113603 Issued in FL
Practice address
86 W Underwood St
MP 80
Orlando, FL 32806-2008
Phone
(888) 912-3648
Fax
(321) 841-4085
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N7236 TX
Internal Medicine Physician 207R00000X ME113603 FL Primary

Addresses

Primary practice location

86 W Underwood St
MP 80
Orlando, FL 32806-2008

Mailing address

86 W Underwood St
MP 80
Orlando, FL 32806-2008
Phone (888) 912-3648

Other identifiers 2

IdentifierTypeStateIssuer
ME113603OtherFLMEDICAL LICENSE
005961600MedicaidFL

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
I20120809000304 FL Practitioner - Internal Medicine 3274658182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

10000 W Colonial Dr
Ocoee, FL 34761-3400
Phone (407) 578-0033

17000 Porter Rd
Winter Garden, FL 34787-8915

1900 Don Wickham Dr
Clermont, FL 34711-1979

22 W Underwood St
Orlando, FL 32806-1110
Phone (407) 648-3800

32 W Gore St
Orlando, FL 32806-1134

380 Rinehart Rd
Lake Mary, FL 32746-2551
Phone (407) 767-1200

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

76 W Underwood St
Orlando, FL 32806-1110

86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME113603FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jul 30, 2012 Accepting new patients
Orlando Physicians Network Inc Internal Medicine CurrentSince Nov 1, 2013 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Jul 30, 2012 Accepting new patients

Locations

86 Underwood St
Orlando, FL 32806
Phone (321) 841-5142

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

86 Underwood St
#80
Orlando, FL 32806
Phone (321) 843-5270

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ecardenasgomez25896@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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 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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1508050048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 W UNDERWOOD ST",
            "address_2": "MP 80",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062008",
            "telephone_number": "888-912-3648",
            "fax_number": "321-841-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 W UNDERWOOD ST",
            "address_2": "MP 80",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062008",
            "telephone_number": "888-912-3648",
            "fax_number": "321-841-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDENAS GOMEZ",
        "first_name": "EDGAR",
        "middle_name": "IVON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N7236",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME113603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME113603",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005961600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.