Individual provider Active NPI

Jorge Luis Sosa, M.D.

  • Specialist
  • Hialeah, FL
National Provider Identifier
1740249796
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME55406 Issued in FL
Practice address
3499 W 4TH Ave
Suite 201
Hialeah, FL 33012-4333
Phone
(305) 558-0411
Fax
(305) 863-3802
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME55406 FL Primary

Addresses

Primary practice location

3499 W 4TH Ave
Suite 201
Hialeah, FL 33012-4333

Mailing address

3499 W 4TH Ave
Suite 201
Hialeah, FL 33012-4333
Phone (305) 558-0411

Other identifiers 1

IdentifierTypeStateIssuer
370582000MedicaidFL

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110928000231 FL Practitioner - General Surgery 7517138308 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME55406FLMDSpecialist

Organizations & group practices 1

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1740249796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3499 W 4TH AVE",
            "address_2": "SUITE 201",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124333",
            "telephone_number": "305-558-0411",
            "fax_number": "305-863-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3499 W 4TH AVE",
            "address_2": "SUITE 201",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124333",
            "telephone_number": "305-558-0411",
            "fax_number": "305-863-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSA",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME55406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370582000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.