Individual provider Active NPI

Michelle Denisse Herrera, M.D

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1659724151
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
304062 Issued in NY
Practice address
10105 Clear Vista St Ste B
Orlando, FL 32832-6376
Phone
(407) 249-1234
Fax
(407) 249-1755
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 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
Pediatrics Physician 208000000X 304062 NY Primary

Addresses

Primary practice location

10105 Clear Vista St Ste B
Orlando, FL 32832-6376

Mailing address

11513 Lake Underhill Rd
Orlando, FL 32825-5001
Phone (407) 249-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20181218004046 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5890030936

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Pediatrics, Inc CurrentSince Jan 2, 2022 Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson, LLC Pediatrics CurrentSince Mar 27, 2022 Accepting new patients
First Choice Pediatrics, Inc Pediatrics CurrentSince Jan 2, 2022 Accepting new patients
Family Tree Medical Group, PA Pediatrics Past Accepting new patients
Kidsville Pediatrics IV, P.a. Pediatrics Past Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics PastSince Feb 13, 2022 Accepting new patients

Locations

10105 Clear Vista St
Ste B
Orlando, FL 32832

11513 Lake Underhill Rd
Orlando, FL 32825

Interoperability endpoints

  • Direct secure messaging: drherrera@rbk.opdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1659724151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11513 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328255001",
            "telephone_number": "407-249-1234",
            "fax_number": "407-249-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10105 CLEAR VISTA ST STE B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326376",
            "telephone_number": "407-249-1234",
            "fax_number": "407-249-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "MICHELLE",
        "middle_name": "DENISSE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "304062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.