Individual provider Active NPI

Lorena L Ejercito

  • Internal Medicine Physician
  • Sarasota, FL
National Provider Identifier
1821088782
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME76113 Issued in FL
Practice address
1921 Waldemere St
Suite 605
Sarasota, FL 34239-2943
Phone
(941) 917-8100
Fax
(941) 917-6334
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME76113 FL Primary

Addresses

Primary practice location

1921 Waldemere St
Suite 605
Sarasota, FL 34239-2943

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600

Other identifiers 2

IdentifierTypeStateIssuer
258270800MedicaidFL
46304OtherFLBCBS

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
I20100419000127 FL Practitioner - Internal Medicine 7911034293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pennsylvania State University College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians
Mastercare Physical Therapy IncGroup PAC ID 6103073499, 51 clinicians
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

1921 Waldemere St
Suite 605
Sarasota, FL 34239-2943
Phone (941) 917-8100

3982 Bee Ridge Rd
Suite K
Sarasota, FL 34233-1210
Phone (941) 377-6700

8429 Tuttle Ave
234 236
Sarasota, FL 34243-2868
Phone (941) 413-1550

Hospital & facility affiliations

  • Empath Home Health Home health agency, Fort Myers, FL, CCN 109786
  • Sarasota Memorial Homecare Home health agency, Sarasota, FL, CCN 107710
  • Haven Home Health Care Home health agency, Riverview, FL, CCN 687113
  • Haven Home Health Care Home health agency, Venice, FL, CCN 687116
  • Patients First Home Care LLC Home health agency, Sarasota, FL, CCN 687176
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359
  • HCA Florida Sarasota Doctors Hospital Hospital, Sarasota, FL, CCN 100166

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME76113FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Internal Medicine CurrentSince Apr 19, 1999 Accepting new patients
SMH Physician Services Inc Past Accepting new patients

Locations

729 S Tamiami Trl
Ste 101
Osprey, FL 34229
Phone (941) 917-8225

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1921 Waldemere St
Ste 605
Sarasota, FL 34239
Phone (941) 331-6181

1921 Waldemere St
Ste 405
Sarasota, FL 34239
Phone (941) 917-3500

Interoperability endpoints

  • Direct secure messaging: lorena.ejercito@fpg.directbygreenway.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1821088782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 WALDEMERE ST",
            "address_2": "SUITE 605",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392943",
            "telephone_number": "941-917-8100",
            "fax_number": "941-917-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJERCITO",
        "first_name": "LORENA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME76113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258270800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46304",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.