Individual provider Active NPI

Jooby John, M.D.

  • Interventional Cardiology Physician
  • Kissimmee, FL
National Provider Identifier
1891897880
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME114823 Issued in FL
Practice address
601 Oak Commons Blvd
Kissimmee, FL 34741-4213
Phone
(407) 846-0626
Fax
(407) 846-2524
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME114823 FL
Interventional Cardiology Physician 207RI0011X ME114823 FL Primary

Addresses

Primary practice location

601 Oak Commons Blvd
Kissimmee, FL 34741-4213

Mailing address

601 Oak Commons Blvd
Kissimmee, FL 34741-4213
Phone (407) 846-0626

Other identifiers 1

IdentifierTypeStateIssuer
ME114823OtherFLSTATE LICENSE

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
I20140130000733 FL Practitioner - Cardiovascular Disease (Cardiology) 1052589710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Associates IncGroup PAC ID 2062300080, 18 clinicians

Practice addresses (Care Compare)

3114 17TH St
Saint Cloud, FL 34769-6021
Phone (407) 846-0626

4529 Edgewater Dr
Orlando, FL 32804-1119
Phone (407) 297-1870

601 Oak Commons Blvd
Kissimmee, FL 34741-4213
Phone 4078460626239

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • HCA Florida Osceola Hospital Hospital, Kissimmee, FL, CCN 100110
  • HCA Florida Poinciana Hospital Hospital, Kissimmee, FL, CCN 100320

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
96.58
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting13
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME114823FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Cardiology Interpretations LLC CurrentSince Aug 15, 2015 Accepting new patients
Cardiovascular Associates Inc Cardiovascular Disease CurrentSince Jan 1, 2014 Accepting new patients
Back Kim MD PC Dba Heartvein Nyc Cardiovascular Disease PastSince Jan 19, 2011 Accepting new patients

Locations

410 Celebration Pl
Ste 210
Celebration, FL 34747
Phone (321) 639-3651

601 Oak Commons Blvd
Kissimmee, FL 34741
Phone (407) 846-0626

339 Cypress Pkwy
Ste 320
Kissimmee, FL 34759
Phone (407) 846-0626

4529 Edgewater Dr
Orlando, FL 32804
Phone (352) 512-9139

3114 17th St
Ste 5
Saint Cloud, FL 34769

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

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

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 4

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1891897880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 OAK COMMONS BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414213",
            "telephone_number": "407-846-0626",
            "fax_number": "407-846-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 OAK COMMONS BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414213",
            "telephone_number": "407-846-0626",
            "fax_number": "407-846-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "JOOBY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME114823",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME114823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME114823",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.