Individual provider Active NPI

Rafael Jimenez, MD

  • Cardiovascular Disease Physician
  • Kissimmee, FL
National Provider Identifier
1568493443
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME0059612 Issued in FL
Practice address
302 W Bass St
Kissimmee, FL 34741-5001
Phone
(407) 518-7999
Fax
(407) 518-9766
NPI assigned
Jul 6, 2006
Last updated
Apr 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME0059612 FL Primary

Addresses

Primary practice location

302 W Bass St
Kissimmee, FL 34741-5001

Mailing address

302 W Bass St
Kissimmee, FL 34741-5001
Phone (407) 518-7999

Other identifiers 6

IdentifierTypeStateIssuer
251215700MedicaidFL
10411101OtherFLCITRUS CARE
06920OtherFLWELLCARE
4380411OtherFLAETNA
4724188OtherFLCIGNA
2102311OtherGHI

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
I20040322000651 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1153212048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

302 W Bass St
Kissimmee, FL 34741-5001
Phone (407) 518-7999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0059612FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primed Healthcare PA Cardiovascular Disease CurrentSince Feb 8, 1996 Accepting new patients
Central Florida Cardiology Interpretations LLC CurrentSince Jun 16, 2012 Accepting new patients
Magda E. Sanchez-Velez, M.D., P.a. Cardiovascular Disease PastSince Mar 1, 2010 Accepting new patients
Greater Tampa Bay Physician Specialists, LLC Past Accepting new patients

Locations

302 W Bass St
Kissimmee, FL 34741
Phone (407) 518-7999

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

Networks

  • Freedom Health HMO Network

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.

Hospital & facility affiliations 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1568493443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W BASS ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415001",
            "telephone_number": "407-518-7999",
            "fax_number": "407-518-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W BASS ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415001",
            "telephone_number": "407-518-7999",
            "fax_number": "407-518-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "RAFAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME0059612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251215700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITRUS CARE",
            "identifier": "10411101",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "06920",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4380411",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4724188",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2102311",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.