Active NPI
Jeffrey R. Koren, M.D.
- Obstetrics & Gynecology Physician
- Ocoee, FL
National Provider Identifier
1780649699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- ME36251
- Practice address
- 885 Sedalia St
Ocoee, FL 34761-3164 - Phone
- (407) 294-2994
- Fax
- (407) 294-2882
- NPI assigned
- Apr 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | ME36251 | FL | Primary |
Addresses
Primary practice location
885 Sedalia St
Ocoee, FL 34761-3164
Mailing address
885 Sedalia Street
Suite 100
Ocoee, FL 34761
Phone (407) 294-2994
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 045791400 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME36251 | FL | MD | Obstetrics & Gynecology Physician |
| 37721 | TN | MD | Obstetrics & Gynecology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566432000000",
"number": "1780649699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "885 SEDALIA STREET",
"address_2": "SUITE 100",
"city": "OCOEE",
"state": "FL",
"postal_code": "34761",
"telephone_number": "407-294-2994",
"fax_number": "407-294-2882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "885 SEDALIA ST",
"city": "OCOEE",
"state": "FL",
"postal_code": "347613164",
"telephone_number": "407-294-2994",
"fax_number": "407-294-2882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOREN",
"first_name": "JEFFREY",
"middle_name": "R.",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-20",
"last_updated": "2019-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "ME36251",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "045791400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocoee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.