Theresa Adadzewa Fynn, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

ME109189 Issued in FL

Practice address

3004 17TH St
Saint Cloud, FL 34769-6011

Phone

(407) 593-2910

Fax

(407) 593-2913

NPI assigned

May 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Endocrinology

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Premier Endocrinology PLLCGroup PAC ID 9234396326, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health St Cloud Hospital Hospital, Saint Cloud, FL, CCN 100302
• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Orlando Health Hospital, Orlando, FL, CCN 100006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

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

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.

• Premier Endocrinology PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Cloud, FL
  • NPI 1033487426
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health System-Sunbelt, Inc

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation
• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  Care Compare affiliation
• Osceolasc LLC

  • General Acute Care Hospital
  • Saint Cloud, FL
  • NPI 1164478442
  Care Compare affiliation

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1669639266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696011",
            "telephone_number": "407-593-2910",
            "fax_number": "407-593-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696011",
            "telephone_number": "407-593-2910",
            "fax_number": "407-593-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYNN",
        "first_name": "THERESA",
        "middle_name": "ADADZEWA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME109189",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME109189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Nicole Fuday, ARNP
• Ralfred G Fuentes
• Daniella Funes
• FWC Perinatal, LLC
• FWC Perinatal, LLC
• Gaia Grove, LLC.
• Israel Galan Rosa
• Yamiris Galban Mendoza
• Waleska Galindez, MD
• Rukmini Gangapersaud, FNP

• Endocrinology, Diabetes & Metabolism Physician in Saint Cloud, FL
• Providers in Saint Cloud, FL by specialty
• Endocrinology, Diabetes & Metabolism Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.