NPIMap

Organization Active NPI

Center for Plastic & Reconstructive Surgery a Professional Association

  • Plastic and Reconstructive Surgery Physician
  • Orlando, FL
National Provider Identifier
1902844038
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY A PROFESSIONAL ASSOCIATION
Practice address
801 N Orange Ave Ste 815
Orlando, FL 32801-5203
Phone
(407) 898-1436
Fax
(407) 898-6330
NPI assigned
Jun 2, 2006
Last updated
Dec 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Authorized official

Name
Pamela L Henry
Title
Office Manager
Phone
(407) 898-1436

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

801 N Orange Ave Ste 815
Orlando, FL 32801-5203

Mailing address

2501 N Orange Avenue
Suite 442
Orlando, FL 32804
Phone (407) 898-1436

Other identifiers 4

IdentifierTypeStateIssuer
168900414910OtherHUMANA
97149OtherFLBCBS OF FL
0110014OtherAETNA
51884OtherFLFL HOSP HEALTHCARE SYSTEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050201000238 FL Part B Supplier - Clinic/Group Practice 5890745483 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL; Winter Park, FL

National Provider Directory

National Provider Directory

Locations

2501 N Orange Ave
Ste 442
Orlando, FL 32804
Phone (407) 303-3692

801 N Orange Ave
Ste 815
Orlando, FL 32801
Phone (407) 898-1436

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1902844038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVENUE",
            "address_2": "SUITE 442",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "407-898-1436",
            "fax_number": "407-898-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N ORANGE AVE STE 815",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328015203",
            "telephone_number": "407-898-1436",
            "fax_number": "407-898-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY A PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-898-1436"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "168900414910",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "97149",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0110014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL HOSP HEALTHCARE SYSTEM",
            "identifier": "51884",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.