Jussep Orlando Fombellida Martinez, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11007910 Issued in FL

Practice address

5564 E Grant St
Orlando, FL 32822-1666

Phone

(321) 235-6230

Fax

(321) 235-6246

NPI assigned

Jul 4, 2020

Last updated

Jan 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keiler Heberto Moreno Rivero, P.aGroup PAC ID 6002153145, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FEAGBD

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.

• Keiler Heberto Moreno Rivero, P.a.

  dba Moreno's Internal Medicine

  • Internal Medicine Physician
  • Celebration, FL
  • NPI 1861974073
  Medicare reassignment Care Compare group NPD
• Health First Center LLC

  • General Practice Physician
  • Orlando, FL
  • NPI 1811831076
  NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Boynton Beach, FL
  • NPI 1467507657
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Miami Lakes, FL
  • NPI 1528113792
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Melbourne, FL
  • NPI 1669548053
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Tallahassee, FL
  • NPI 1972555464
  Care Compare affiliation

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

{
    "created_epoch": "1593820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1831716067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5564 E GRANT ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328221666",
            "telephone_number": "321-235-6230",
            "fax_number": "321-235-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5564 E GRANT ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328221666",
            "telephone_number": "321-235-6230",
            "fax_number": "321-235-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMBELLIDA MARTINEZ",
        "first_name": "JUSSEP",
        "middle_name": "ORLANDO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-04",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin M Foley, DDS
• Lillian Velma Folley, ARNP
• Megan Nicole Folsom
• Samantha Ann Folsom, CRNP
• Shannon Folsom
• Kathleen Fondaw
• Katherine Fonfara, PHARMD
• Tyler Fong, MD
• Jessica Fonseca, APRN
• Keishla Marie Fonseca

• Family Nurse Practitioner in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.