NPIMap

Organization Active NPI

Infectious Diseases Specialty Associates PLLC

  • Infectious Disease Physician
  • Ocala, FL
National Provider Identifier
1871084426
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME75316 Issued in FL
Legal business name
INFECTIOUS DISEASES SPECIALTY ASSOCIATES PLLC
Practice address
150 SE 17TH St Ste 801
Ocala, FL 34471
Phone
(352) 362-6104
NPI assigned
May 18, 2018
Last updated
Aug 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Authorized official

Name
Dr. Anteneh M. Addisu, MP, PHDNPI 1922052471
Title
President
Phone
(352) 362-6104

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
Infectious Disease Physician 207RI0200X ME75316 FL Primary

Addresses

Primary practice location

150 SE 17TH St Ste 801
Ocala, FL 34471

Mailing address

PO Box 3716
Ocala, FL 34478-3716
Phone (352) 362-6104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180918003711 FL Part B Supplier - Clinic/Group Practice 0749531598 Receives reassigned benefits from 9 practitioners
Practice locations: Ocala, FL

National Provider Directory

National Provider Directory

Locations

150 SE 17th St
Ste 801
Ocala, FL 34471
Phone (352) 237-7646

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1871084426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3716",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344783716",
            "telephone_number": "352-362-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SE 17TH ST STE 801",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34471",
            "telephone_number": "352-362-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES SPECIALTY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-08-24",
        "status": "A",
        "authorized_official_last_name": "ADDISU",
        "authorized_official_first_name": "ANTENEH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-362-6104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MP, PHD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME75316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.