Individual provider Active NPI

Francis B Pellegrino, MD

  • Family Medicine Physician
  • Clermont, FL
National Provider Identifier
1730172479
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME55766 Issued in FL
Practice address
1745 E Hwy 50
Suite C
Clermont, FL 34711-5037
Phone
(352) 394-8060
Fax
(352) 708-6420
NPI assigned
Aug 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME55766 FL Primary

Addresses

Primary practice location

1745 E Hwy 50
Suite C
Clermont, FL 34711-5037

Mailing address

18550 US Highway 441
Ste a
Mount Dora, FL 32757-6751
Phone (727) 992-6658

Other identifiers 4

IdentifierTypeStateIssuer
593516436OtherTRICARE
054022600MedicaidFL
09743OtherBCBS FLORIDA
P00390401OtherRR PALMETTO GBA

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeview Healthcare System, LLCGroup PAC ID 8921074733, 25 clinicians

Practice addresses (Care Compare)

10250 SE 167TH Place Rd
Unit 5
Summerfield, FL 34491-8682
Phone (352) 307-9925

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME55766FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LRMC Urgent Care Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1730172479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18550 US HIGHWAY 441",
            "address_2": "STE A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576751",
            "telephone_number": "727-992-6658",
            "fax_number": "352-503-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 E HWY 50",
            "address_2": "SUITE C",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347115037",
            "telephone_number": "352-394-8060",
            "fax_number": "352-708-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINO",
        "first_name": "FRANCIS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME55766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "593516436",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054022600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FLORIDA",
            "identifier": "09743",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PALMETTO GBA",
            "identifier": "P00390401",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.