Individual provider Active NPI

Jose Alberto Hernandez Irizarry, DC

  • Chiropractor
  • Celebration, FL
National Provider Identifier
1811776446
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14701 Issued in FL
Practice address
2940 Mallory Cir Ste 205
Celebration, FL 34747-1818
Phone
(407) 507-6976
NPI assigned
Sep 25, 2023
Last updated
Sep 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH14701 FL Primary

Addresses

Primary practice location

2940 Mallory Cir Ste 205
Celebration, FL 34747-1818

Mailing address

116 Sunny Day Way
Davenport, FL 33897-8597
Phone (386) 214-4558

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260415001624 FL Practitioner - Chiropractic 6305312638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspring Health - Orange City, LLCGroup PAC ID 5193093490, 4 clinicians

Practice addresses (Care Compare)

2275 N Volusia Ave
Suite 100
Orange City, FL 32763-2833
Phone (386) 775-6879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH14701FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Macdermott Group, LLC Chiropractor CurrentSince Oct 1, 2023 Accepting new patients

Locations

2940 Mallory Cir
Ste 205
Kissimmee, FL 34747
Phone (407) 507-6976

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1811776446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 SUNNY DAY WAY",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338978597",
            "telephone_number": "386-214-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 MALLORY CIR STE 205",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347471818",
            "telephone_number": "407-507-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ IRIZARRY",
        "first_name": "JOSE",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.