Individual provider Active NPI

Jamie Michelle Demaio, M.D.

  • General Practice Physician
  • Lakeland, FL
National Provider Identifier
1720047954
Registry record updated Apr 10, 2019
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Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
10638 Issued in PR
Practice address
1417 Lakeland Hills Blvd Ste 204
Lakeland, FL 33805-3208
Phone
(863) 688-5811
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 10638 PR Primary

Addresses

Primary practice location

1417 Lakeland Hills Blvd Ste 204
Lakeland, FL 33805-3208

Mailing address

1417 Lakeland Hills Blvd Ste 204
Lakeland, FL 33805-3208
Phone (863) 688-5811

Other identifiers 9

IdentifierTypeStateIssuer
200090OtherPRMEDICARE Y MUCHO MAS
201780OtherPRUTI PREFERRED
060882OtherPRCRUZ AZUL
3110638OtherPRU.I.A.
6560029OtherPRHUMANA INSURANCE
PG 3787OtherPRPANAMERICAN LIFE INSURANC
012232OtherPRHUMANA HEALTH PLAN
2104OtherPRPREFERRED MEDICARE CHOICE
89997DEOtherPRTRIPLE S

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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

Enrollment IDStateProvider typePAC IDDetails
I20120919000713 PR Practitioner - General Practice 1557519303 Practice locations: Guayanilla, PR

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1720047954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 LAKELAND HILLS BLVD STE 204",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053208",
            "telephone_number": "863-688-5811",
            "fax_number": "863-688-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 LAKELAND HILLS BLVD STE 204",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053208",
            "telephone_number": "863-688-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAIO",
        "first_name": "JAMIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "10638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE Y MUCHO MAS",
            "identifier": "200090",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTI PREFERRED",
            "identifier": "201780",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "060882",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U.I.A.",
            "identifier": "3110638",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA INSURANCE",
            "identifier": "6560029",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PANAMERICAN LIFE INSURANC",
            "identifier": "PG 3787",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA HEALTH PLAN",
            "identifier": "012232",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICARE CHOICE",
            "identifier": "2104",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "89997DE",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.