NPIMap

Individual provider Active NPI

Luis Alejandro Servin Abad, M.D.

  • Gastroenterology Physician
  • Lakeland, FL
National Provider Identifier
1760640130
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME117173 Issued in FL
Practice address
2350 Brandon Rd
Lakeland, FL 33803-3267
Phone
(305) 301-1683
NPI assigned
Jun 1, 2008
Last updated
Mar 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 41603 KY
Gastroenterology Physician 207RG0100X 41603 KY
Gastroenterology Physician 207RG0100X ME117173 FL Primary

Addresses

Primary practice location

2350 Brandon Rd
Lakeland, FL 33803-3267

Mailing address

2350 Brandon Rd
Lakeland, FL 33803-3267
Phone (305) 301-1683

Other practice location 1

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140502001704 FL Practitioner - Gastroenterology 3971736646 Reassigns benefits to 1 organization
I20170927002536 KY Practitioner - Gastroenterology 3971736646 Reassigns benefits to 1 organization
I20191221000445 MN Practitioner - GastroenterologyPractitioner - Internal Medicine 3971736646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

1324 Lakeland Hill Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1248

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

3525 Lakeland Hills Blvd
Lakeland, FL 33805-1965
Phone (863) 603-6565

Attn Managed Care
1324 Lakeland HLLS Blvd
Lakeland, FL 33805-4543

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy72
Upper gastrointestinal (GI) endoscopy for acid reflux177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41603KYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
St. Cloud Hospital Current Accepting new patients
Kentucky Medical Services Foundation, Inc Internal Medicine CurrentSince Aug 13, 2017 Accepting new patients
Centracare Clinic CurrentSince Nov 2, 2019 Accepting new patients
St Cloud Pathologists PA Current Accepting new patients
Centracare Clinic CurrentSince Nov 2, 2019 Accepting new patients
St. Cloud Hospital CurrentSince Mar 25, 2020 Accepting new patients
St. Cloud Hospital CurrentSince Mar 25, 2020 Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1900 Centracare Cir
Ste 2400
Saint Cloud, MN 56303
Phone (320) 229-4916

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1760640130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 BRANDON RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033267",
            "telephone_number": "305-301-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 BRANDON RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033267",
            "telephone_number": "305-301-1683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1324 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "33805",
            "country_code": "US",
            "telephone_number": "863-687-1321",
            "fax_number": "863-284-1730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERVIN ABAD",
        "first_name": "LUIS",
        "middle_name": "ALEJANDRO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-01",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "41603",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "41603",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME117173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.