NPIMap

Organization Active NPI

Cardiovascular Associates Inc

  • Cardiovascular Disease Physician
  • Kissimmee, FL
National Provider Identifier
1508867870
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
91700049142 Issued in FL
Legal business name
CARDIOVASCULAR ASSOCIATES INC
Practice address
601 Oak Commons Blvd
Kissimmee, FL 34741-4213
Phone
(407) 846-0626
Fax
(407) 846-2371
NPI assigned
Aug 9, 2005
Last updated
Jan 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Authorized official

Name
Dr. Johnson P Massey, MDNPI 1265432231
Title
President
Phone
(407) 846-0626

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 Physician 207RC0000X 91700049142 FL Primary

Addresses

Primary practice location

601 Oak Commons Blvd
Kissimmee, FL 34741-4213

Mailing address

601 Oak Commons Blvd
Kissimmee, FL 34741-4213
Phone (407) 846-0626

Other identifiers 1

IdentifierTypeStateIssuer
372298800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101112000947 FL Part B Supplier - Clinic/Group Practice 2062300080 Receives reassigned benefits from 20 practitioners
Practice locations: Saint Cloud, FL; Orlando, FL; Kissimmee, FL; Celebration, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0939811Cardiovascular Associates Inc601 Oak Commons Blvd, Kissimmee, FL 34741Certificate of waiverFeb 1, 2028

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

410 Celebration Pl
Ste 210
Celebration, FL 34747
Phone (321) 639-3651

339 Cypress Pkwy
Ste 320
Kissimmee, FL 34759
Phone (407) 846-0626

601 Oak Commons Blvd
Kissimmee, FL 34741
Phone (407) 846-0626

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCFIAD

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1508867870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 OAK COMMONS BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414213",
            "telephone_number": "407-846-0626",
            "fax_number": "407-846-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 OAK COMMONS BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414213",
            "telephone_number": "407-846-0626",
            "fax_number": "407-846-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "MASSEY",
        "authorized_official_first_name": "JOHNSON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-846-0626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "91700049142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372298800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.