Individual provider Active NPI

Karen Elizabeth Jorge

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1558879114
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110975 Issued in FL
Practice address
1400 N Semoran Blvd Ste E
Orlando, FL 32807-3562
Phone
(407) 823-8421
Fax
(407) 823-8195
NPI assigned
Jan 17, 2018
Last updated
May 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110975 FL Primary
Clinical Social Worker 1041C0700X
Psychiatry Physician 2084P0800X ME124792 FL

Addresses

Primary practice location

1400 N Semoran Blvd Ste E
Orlando, FL 32807-3562

Mailing address

5450 Los Palma Vista Dr
Orlando, FL 32837-4608
Phone (786) 506-0389

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211111002808 FL Practitioner - Physician Assistant 7810386877 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Dermatology Health LLCGroup PAC ID 9032552393, 2 clinicians
Guidewell Sanitas I, LLCGroup PAC ID 9537447107, 124 clinicians

Practice addresses (Care Compare)

Orando, FL 32832
Phone (321) 414-4829

2000 NW 87TH Ave
Suite 101 102
Doral, FL 33172-2654
Phone (844) 665-4827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
ME124792FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guidewell Sanitas I, LLC Multi-Specialty CurrentSince Jan 26, 2023 Accepting new patients
Meharry Health Network, PC Multi-Specialty CurrentSince Jul 20, 2023 Accepting new patients
Compass Counseling Services,LLC PastSince May 25, 2021 Accepting new patients

Locations

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1558879114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 LOS PALMA VISTA DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328374608",
            "telephone_number": "786-506-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N SEMORAN BLVD STE E",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073562",
            "telephone_number": "407-823-8421",
            "fax_number": "407-823-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGE",
        "first_name": "KAREN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-17",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110975",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME124792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.