Active NPI
Jorge J Carrillo, MD
- Rheumatology Physician
- Palm Beach Gardens, FL
National Provider Identifier
1740258359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- ME37325
- Practice address
- 11211 Prosperity Farms Rd
D127
Palm Beach Gardens, FL 33410-3446 - Phone
- (561) 622-6111
- Fax
- (561) 768-7999
- NPI assigned
- Mar 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | ME37325 | FL | Primary |
Addresses
Primary practice location
11211 Prosperity Farms Rd
D127
Palm Beach Gardens, FL 33410-3446
Mailing address
PO Box 310754
Dept 4101
Boca Raton, FL 33431-0754
Phone (561) 622-6111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61100X | Other | FL | MEDICARE ID |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical Group of South Florida, Inc | Past | Accepting new patients |
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.
-
- Specialist
- West Palm Beach, FL
- NPI 1023454063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428969600000",
"number": "1740258359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 310754",
"address_2": "DEPT 4101",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334310754",
"telephone_number": "561-622-6111",
"fax_number": "561-244-2591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11211 PROSPERITY FARMS RD",
"address_2": "D127",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334103446",
"telephone_number": "561-622-6111",
"fax_number": "561-768-7999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "JORGE",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2015-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "FL",
"license": "ME37325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "61100X",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.