NPIMap

Individual provider Active NPI

Erwing Armando Parra de Jesus, MD

  • Internal Medicine Physician
  • Lakeland, FL
National Provider Identifier
1669657409
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
132618 Issued in FL
Practice address
4715 S Florida Ave Ste 200
Lakeland, FL 33813
Phone
(863) 209-7004
NPI assigned
Dec 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16945 PR
Internal Medicine Physician 207R00000X 132618 FL Primary

Addresses

Primary practice location

4715 S Florida Ave Ste 200
Lakeland, FL 33813

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

Other practice location 1

206 N Florida Ave
Lakeland, FL 33801-4902
Phone (863) 209-7003

Other practice location 2

206 N Florida Ave
Lakeland, FL 33801-4902
Phone (863) 209-7003

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
I20170907002378 FL Practitioner - Internal Medicine 3375626823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Care Hospitalists PLGroup PAC ID 5092753632, 66 clinicians

Practice addresses (Care Compare)

4315 Highland Park Blvd
Suite D
Lakeland, FL 33813-1639
Phone (863) 816-5884

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132618FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Sep 11, 2017 Accepting new patients
Advanced Care Hospitalists PL CurrentSince Jan 1, 2023 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Sep 11, 2017 Accepting new patients
Municipio de Sabana Grande Past Accepting new patients

Locations

4315 Highland Park Blvd
Ste D
Lakeland, FL 33813
Phone (863) 816-5884

4315 Highland Park Blvd
Ste A
Lakeland, FL 33813
Phone (813) 651-1085

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

206 N Florida Ave
Lakeland, FL 33801
Phone (863) 209-7003

4715 S Florida Ave
Ste 200
Lakeland, FL 33813
Phone (863) 209-7004

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

Organizations & group practices 4

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 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": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1669657409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 S FLORIDA AVE STE 200",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33813",
            "telephone_number": "863-209-7004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 N Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338014902",
            "country_code": "US",
            "telephone_number": "863-209-7003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 N Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338014902",
            "country_code": "US",
            "telephone_number": "863-209-7003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARRA DE JESUS",
        "first_name": "ERWING",
        "middle_name": "ARMANDO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16945",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "132618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.