Jorge Ballesteros, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9103585 Issued in FL

Practice address

7824 Lake Underhill Rd
Suite a
Orlando, FL 32822-8201

Phone

(407) 282-2001

Fax

(407) 282-2028

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

No

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Colmedical Care LLC

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1427525963
  Medicare reassignment Authorized official
• Integrated Medical Care, LLC

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1952533218
  Medicare reassignment

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1689657066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7824 LAKE UNDERHILL RD",
            "address_2": "SUITE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228201",
            "telephone_number": "407-282-2001",
            "fax_number": "407-282-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7824 LAKE UNDERHILL RD",
            "address_2": "SUITE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228201",
            "telephone_number": "407-282-2001",
            "fax_number": "407-282-2028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "483 N Semoran Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327923800",
            "country_code": "US",
            "telephone_number": "407-500-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLESTEROS",
        "first_name": "JORGE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9103585",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard A Ballentine
• Sarah Baller, ATC, LAT, CES
• Kimberly Ann Ballerino, APRN
• Milva Ballester
• Kyonett Ballesteros Garcia
• Jorge Manuel Ballesteros, CRNA
• Ximena Ballesteros
• Audrey Smith Ballin
• Cristan Ballmann, APRN
• Jason Willard Balls, PA

• Medical Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.