NPIMap

Organization Active NPI

Orlando Orthopaedic Center MD PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Casselberry, FL
National Provider Identifier
1780116343
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
ORLANDO ORTHOPAEDIC CENTER MD PA
Practice address
2911 Red Bug Lake Rd
Casselberry, FL 32707-5929
Phone
(407) 699-9511
Fax
(407) 699-0267
NPI assigned
Apr 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Authorized official

Name
Kevin C Joyce
Title
Executive Director
Phone
(407) 254-2555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

2911 Red Bug Lake Rd
Casselberry, FL 32707-5929

Mailing address

25 W Crystal Lake St
Orlando, FL 32806-4475
Phone (407) 254-2500

Other names 1

  • Orlando Orthopaedic Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040511001656 FL Part B Supplier - Clinic/Group Practice 3678562840 Receives reassigned benefits from 59 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Casselberry, FL; Lake Mary, FL; Orlando, FL; Oviedo, FL; Winter Garden, FL; Winter Park, FL
O20190618002135 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3678562840 Practice locations: Casselberry, FL

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Orlando Orthopaedic Center MD PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25 W Crystal Lake St
Orlando, FL 32806
Phone (407) 254-2500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1780116343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W CRYSTAL LAKE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064475",
            "telephone_number": "407-254-2500",
            "fax_number": "407-423-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 RED BUG LAKE RD",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075929",
            "telephone_number": "407-699-9511",
            "fax_number": "407-699-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLANDO ORTHOPAEDIC CENTER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-01",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "JOYCE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "407-254-2555"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orlando Orthopaedic Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orlando Orthopaedic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Casselberry, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.