NPIMap

Individual provider Active NPI

Jorge Miguel Kourie, M.D.

  • Nephrology Physician
  • Orlando, FL
National Provider Identifier
1659585552
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME104748 Issued in FL
Practice address
2501 N Orange Ave
Suite 537N
Orlando, FL 32804-4603
Phone
(407) 894-4693
Fax
(407) 896-0569
NPI assigned
May 9, 2007
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME104748 FL Primary

Addresses

Primary practice location

2501 N Orange Ave
Suite 537N
Orlando, FL 32804-4603

Mailing address

2180 W Sr 434 Ste 1164
Longwood, FL 32779-5008
Phone (407) 894-4693

Other identifiers 2

IdentifierTypeStateIssuer
0169951MedicaidNJ
001406400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091023000618 FL Practitioner - NeurologyPractitioner - Internal Medicine 4789760547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Central Florida, P.a.Group PAC ID 2567359375, 34 clinicians

Practice addresses (Care Compare)

2501 N Orange Ave
Suite 537N
Orlando, FL 32804-4674
Phone (407) 894-4693

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Central Florida, P.a. Nephrology CurrentSince Sep 1, 2012 Accepting new patients
Renal Access of Central Florida LLC Nephrology Past Accepting new patients

Locations

2180 W Sr 434
Ste 1164
Longwood, FL 32779
Phone (407) 894-4693

2501 N Orange Ave
Ste 537N
Orlando, FL 32804
Phone (407) 894-4693

807 S Orlando Ave
Ste C
Winter Park, FL 32789
Phone (407) 894-4693

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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 9

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1659585552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 W SR 434 STE 1164",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795008",
            "telephone_number": "407-894-4693",
            "fax_number": "407-261-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE",
            "address_2": "SUITE 537N",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-894-4693",
            "fax_number": "407-896-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURIE",
        "first_name": "JORGE",
        "middle_name": "MIGUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME104748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0169951",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001406400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.