Samuel E Crockett, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

ME31027 Issued in FL

Practice address

2520 N Orange Ave
Suite 102
Orlando, FL 32804-4638

Phone

(407) 303-2801

Fax

(407) 303-2805

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1679517171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 N ORANGE AVE",
            "address_2": "SUITE 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044638",
            "telephone_number": "407-303-2801",
            "fax_number": "407-303-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 N ORANGE AVE",
            "address_2": "SUITE 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044638",
            "telephone_number": "407-303-2801",
            "fax_number": "407-303-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "SAMUEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME31027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "48932",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Crisanto
• Tamara Crispin, APRN
• Ingrid Cristian, MD
• Jane Buzzell Critchett, PA-C
• Critical Care and Hospital Medicine Group PLLC
• Casey Roberts Croes, PA-C
• Kira Amanda Croff, ARNP
• Kyle M. Crofoot, M.D.
• Miya Croft
• Victoria Croft

• Endocrinology, Diabetes & Metabolism Physician in Orlando, FL
• Providers in Orlando, 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 Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.