Organization Active NPI

Pulmonary Disease Specialists, PA

  • Pulmonary Disease Physician
  • Kissimmee, FL
National Provider Identifier
1649484809
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONARY DISEASE SPECIALISTS, PA
Practice address
1121 N Central Ave
Suite B
Kissimmee, FL 34741-4405
Phone
(407) 933-1221
Fax
(407) 933-1132
NPI assigned
May 9, 2007
Last updated
Mar 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Authorized official

Name
Dr. Thomas W O'Brien, M.D.NPI 1396700803
Title
President
Phone
(407) 933-1221

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
Pulmonary Disease Physician 207RP1001X Primary

Addresses

Primary practice location

1121 N Central Ave
Suite B
Kissimmee, FL 34741-4405

Mailing address

1121 N Central Ave
Suite B
Kissimmee, FL 34741-4405
Phone (407) 933-1221

Other identifiers 1

IdentifierTypeStateIssuer
255536100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041116001061 FL Part B Supplier - Clinic/Group Practice 4789648072 Receives reassigned benefits from 23 practitioners
Practice locations: Davenport, FL; Kissimmee, FL

National Provider Directory

National Provider Directory

Locations

235 Citrus Tower Blvd
Clermont, FL 34711
Phone (321) 972-4122

40124 Highway 27
Ste 202
Davenport, FL 33837
Phone (863) 422-5331

1121 N Central Ave
Ste A
Kissimmee, FL 34741
Phone (407) 933-2210

1121 N Central Ave
Ste C
Kissimmee, FL 34741

290 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 933-1221

700 W Vine St
Kissimmee, FL 34741

1012 Cypress Pkwy
Poinciana, FL 34759
Phone (470) 933-1423

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

3114 17th St
Saint Cloud, FL 34769
Phone (407) 846-0626

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1649484809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 N CENTRAL AVE",
            "address_2": "SUITE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414405",
            "telephone_number": "407-933-1221",
            "fax_number": "407-933-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 N CENTRAL AVE",
            "address_2": "SUITE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414405",
            "telephone_number": "407-933-1221",
            "fax_number": "407-933-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY DISEASE SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-933-1221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255536100",
            "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 Mar 18, 2015; 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.