NPIMap

Organization Active NPI

Avant Concierge Urology, LLC

  • Medical Specialty Clinic/Center
  • Winter Garden, FL
National Provider Identifier
1578168019
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
AVANT CONCIERGE UROLOGY, LLC
Practice address
15548 W Colonial Dr
Winter Garden, FL 34787-9556
Phone
(140) 784-2830
Fax
(407) 650-2724
NPI assigned
Dec 2, 2020
Last updated
Dec 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Authorized official

Name
Sijo Joseph Parekattil, MDNPI 1417908013
Title
Owner/President
Phone
(407) 547-1654

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
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

15548 W Colonial Dr
Winter Garden, FL 34787-9556

Mailing address

15548 W Colonial Dr
Winter Garden, FL 34787-9556
Phone (140) 784-2830

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@avantconciergeurol.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211120000190 FL Part B Supplier - Clinic/Group Practice 3779972351 Receives reassigned benefits from 2 practitioners
Practice locations: Winter Garden, FL

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: info@avantconciergeurol.com

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606867200000",
    "number": "1578168019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15548 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347879556",
            "telephone_number": "140-784-2830",
            "fax_number": "407-650-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15548 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347879556",
            "telephone_number": "140-784-2830",
            "fax_number": "407-650-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANT CONCIERGE UROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "PAREKATTIL",
        "authorized_official_first_name": "SIJO",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "407-547-1654",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@avantconciergeurol.com",
            "affiliation": "N",
            "endpointDescription": "Company email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15548 W Colonial Dr",
            "city": "Winter Garden",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347879556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.