Individual provider Active NPI

Juan Diego Rondon, MD

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1578025169
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME155174 Issued in FL
Practice address
1515 SW Archer Rd
Gainesville, FL 32608-1134
Phone
(352) 733-0111
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X ME155174 FL Primary

Addresses

Primary practice location

1515 SW Archer Rd
Gainesville, FL 32608-1134

Mailing address

11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone (352) 592-2757

Other practice location 1

11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone (351) 592-2755

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
I20220808002430 FL Practitioner - Emergency Medicine 4082096060 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone (352) 596-6632

Hospital & facility affiliations

  • HCA Florida Oak Hill Hospital Hospital, Brooksville, FL, CCN 100264
  • HCA Florida Citrus Hospital Hospital, Inverness, FL, CCN 100023
  • HCA Florida Brandon Hospital Hospital, Brandon, FL, CCN 100243
  • HCA Florida South Tampa Hospital Hospital, Tampa, FL, CCN 100206

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME155174FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Emergency Physicians Kang and Associates MD LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2022 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2022 Accepting new patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Ridgewood Emergency Group, LLC Emergency Medicine CurrentSince Jul 2, 2024 Accepting new patients
Ridgewood Emergency Group, LLC Emergency Medicine CurrentSince Jul 2, 2024 Accepting new patients

Locations

11375 Cortez Blvd
Fl Oak
Brooksville, FL 34613
Phone (352) 592-2753

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1909 E Highway 50
Clermont, FL 34711
Phone (352) 717-3800

40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1515 SW Archer Rd
Gainesville, FL 32608
Phone (352) 265-0916

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

6945 Cypress Gardens Blvd
Winter Haven, FL 33884
Phone (863) 419-2496

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 6

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1578025169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11375 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135409",
            "telephone_number": "352-592-2757",
            "fax_number": "352-591-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081134",
            "telephone_number": "352-733-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11375 Cortez Blvd",
            "address_purpose": "LOCATION",
            "city": "Brooksville",
            "state": "FL",
            "postal_code": "346135409",
            "country_code": "US",
            "telephone_number": "351-592-2755",
            "fax_number": "352-592-2753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RONDON",
        "first_name": "JUAN",
        "middle_name": "DIEGO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME155174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.