NPIMap

Individual provider Active NPI

Luis F Congote, DDS

  • General Practice Dentistry
  • Winter Haven, FL
National Provider Identifier
1679774426
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN12668 Issued in FL
Practice address
1514 1St St N
Winter Haven, FL 33881-2476
Phone
(863) 291-5110
Fax
(863) 291-5128
NPI assigned
May 30, 2007
Last updated
Mar 2, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN12668 FL Primary

Addresses

Primary practice location

1514 1St St N
Winter Haven, FL 33881-2476

Mailing address

47 5TH St NW
Winter Haven, FL 33881-4672
Phone (863) 291-5110

Other identifiers 1

IdentifierTypeStateIssuer
019764900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN12668FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. General Practice Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc Past Accepting new patients
Central Florida Health Care Inc General Practice Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. General Practice Past Accepting new patients
Central Florida Health Care, Inc General Practice Past Accepting new patients

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: luis.congote.1@12125.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1679774426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 5TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814672",
            "telephone_number": "863-291-5110",
            "fax_number": "863-291-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338812476",
            "telephone_number": "863-291-5110",
            "fax_number": "863-291-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGOTE",
        "first_name": "LUIS",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN12668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019764900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.