Organization Active NPI

Edgard Janer MD PA

  • Rheumatology Physician
  • Tampa, FL
National Provider Identifier
1790916369
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
ME0065277 Issued in FL
Legal business name
EDGARD JANER MD PA
Practice address
3411 W Fletcher Ave Ste a
Tampa, FL 33618-2813
Phone
(813) 962-4119
Fax
(813) 962-3278
NPI assigned
Jul 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2009

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

Authorized official

Name
Edgard Janer, MDNPI 1154353555
Title
President
Phone
(813) 962-4119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X ME0065277 FL Primary

Addresses

Primary practice location

3411 W Fletcher Ave Ste a
Tampa, FL 33618-2813

Mailing address

PO Box 342159
Tampa, FL 33694
Phone (813) 962-4119

Other identifiers 1

IdentifierTypeStateIssuer
253149600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091029000105 FL Part B Supplier - Clinic/Group Practice 7113064890 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255910400000",
    "number": "1790916369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 342159",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33694",
            "telephone_number": "813-962-4119",
            "fax_number": "813-962-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 W FLETCHER AVE STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182813",
            "telephone_number": "813-962-4119",
            "fax_number": "813-962-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGARD JANER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-10-19",
        "status": "A",
        "authorized_official_last_name": "JANER",
        "authorized_official_first_name": "EDGARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-962-4119",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "ME0065277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253149600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2009; 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.