Individual provider Active NPI

Jason Crespo, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Orlando, FL
National Provider Identifier
1790123487
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME144916 Issued in FL
Practice address
125 W Copeland Dr
Orlando, FL 32806-2101
Phone
(218) 417-0903
Fax
(321) 843-2267
NPI assigned
Jun 5, 2013
Last updated
Apr 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 266170 MA
Plastic and Reconstructive Surgery Physician 2086S0122X ME144916 FL Primary

Addresses

Primary practice location

125 W Copeland Dr
Orlando, FL 32806-2101

Mailing address

125 W Copeland Dr
Orlando, FL 32806-2101
Phone (218) 417-0903

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drj@gardnerplasticsurgery.com Direct

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
I20200720001334 FL Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 2961633094 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
University of Connecticut School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

62 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME144916FLMDPlastic and Reconstructive Surgery Physician
266170MAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2023 Accepting new patients
Mid-Florida Dermatology Associates P.a. CurrentSince Dec 1, 2021 Accepting new patients
Gardner Plastic Surgery Inc CurrentSince Sep 1, 2020 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2023 Accepting new patients

Locations

1250 Pine Ridge Rd
Ste 101C
Naples, FL 34108
Phone (239) 566-2611

100 W Gore St
Ste 602
Orlando, FL 32806
Phone (407) 839-3999

125 W Copeland Dr
Orlando, FL 32806
Phone (321) 841-7090

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

62 Columbia St
Orlando, FL 32806
Phone (321) 214-4903

7652 Ashley Park Ct
Ste 305
Orlando, FL 32835
Phone (407) 839-0127

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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 1

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": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1790123487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W COPELAND DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062101",
            "telephone_number": "218-417-0903",
            "fax_number": "321-843-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W COPELAND DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062101",
            "telephone_number": "218-417-0903",
            "fax_number": "321-843-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESPO",
        "first_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-05",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MA",
            "license": "266170",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME144916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drj@gardnerplasticsurgery.com",
            "affiliation": "N",
            "endpointDescription": "nextech email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1250 Pine Ridge Rd Ste 101C",
            "city": "Naples",
            "state": "FL",
            "country_code": "US",
            "postal_code": "341088913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.