NPIMap

Organization Active NPI

Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
National Provider Identifier
1912101650
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PARAGON EMERGENCY SERVICES LLC
Practice address
200 Avenue F NE
Winter Haven, FL 33881-4131
Phone
(863) 293-1121
NPI assigned
Jun 14, 2007
Last updated
Oct 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Dr. Michael D Corvini, M.D.
Title
President
Phone
(800) 424-3672

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatric Emergency Medicine (Pediatrics) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0204X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

200 Avenue F NE
Winter Haven, FL 33881-4131

Mailing address

1643 NW 136TH Ave Ste 100
Sunrise, FL 33323-2857
Phone (800) 424-3672

Other identifiers 3

IdentifierTypeStateIssuer
280167102MedicaidFL
280167100MedicaidFL
DH0458OtherFLRAILROAD MEDICARE

Other names 1

  • Paragon Emergency Services Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080310000143 FL Part B Supplier - Clinic/Group Practice 8628153087 Receives reassigned benefits from 1,143 practitioners
Practice locations: Pensacola, FL; Orange Park, FL; Quincy, FL; Saint Johns, FL; Spring Hill, FL; St Augustine, FL; Tallahassee, FL; The Villages, FL…

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2554 Blanding Blvd
Middleburg, FL 32068
Phone (904) 264-3200

4610 Pea Ridge Connector Rd
Pace, FL 32571
Phone (850) 304-0600

4610 Pea Ridge Connector Rd
#R
Pace, FL 32571

462541 State Road 200
Yulee, FL 32097
Phone (904) 391-6300

Practitioners & affiliated clinicians

Practitioners 1,182

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 1,182

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1912101650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 NW 136TH AVE STE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232857",
            "telephone_number": "800-424-3672",
            "fax_number": "954-377-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "863-293-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON EMERGENCY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "CORVINI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-424-3672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280167102",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280167100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DH0458",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paragon Emergency Services Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Paragon Emergency Services Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.