Individual provider Active NPI

Christian Theodotou

  • Neurological Surgery Physician
  • Orlando, FL
National Provider Identifier
1659765956
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME167109 Issued in FL
Practice address
265 E Rollins St Ste 12000
Orlando, FL 32804-5571
Phone
(407) 975-0200
Fax
(407) 975-1247
NPI assigned
Mar 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME167109 FL Primary

Addresses

Primary practice location

265 E Rollins St Ste 12000
Orlando, FL 32804-5571

Mailing address

265 E Rollins St Ste 12000
Orlando, FL 32804-5571
Phone (407) 975-0200

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
I20240710003110 FL Practitioner - Neurosurgery 1052856408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Miami, LM Miller School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Fairbanks Partners LLCGroup PAC ID 8820303621, 37 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 975-0200

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion46
Laminectomy or laminotomy (partial removal of spine bones)13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairbanks Partners LLC Neurological Surgery CurrentSince Jul 15, 2024 Accepting new patients
Fairbanks Partners LLC Neurological Surgery CurrentSince Jul 15, 2024 Accepting new patients
Orlando Neurosurgery, P.a. Neurological Surgery Past Accepting new patients

Locations

400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000

265 E Rollins St
Ste 12000
Orlando, FL 32804

1605 W Fairbanks Ave
Winter Park, FL 32789
Phone (407) 845-8356

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIBACD

Organizations & group practices 3

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 3

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1659765956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 E ROLLINS ST STE 12000",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045571",
            "telephone_number": "407-975-0200",
            "fax_number": "407-975-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 E ROLLINS ST STE 12000",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045571",
            "telephone_number": "407-975-0200",
            "fax_number": "407-975-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOTOU",
        "first_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME167109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.