Individual provider Active NPI

Andrew M Georgeson, DO

  • Surgery Physician
  • West Palm Beach, FL
National Provider Identifier
1922017938
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS14725 Issued in FL
Practice address
4700 N Congress Ave Ste 301
West Palm Beach, FL 33407-3292
Phone
(800) 991-6117
Fax
(888) 812-8191
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X AG009192 MI
Surgery Physician 208600000X OS14725 FL Primary

Addresses

Primary practice location

4700 N Congress Ave Ste 301
West Palm Beach, FL 33407-3292

Mailing address

3810 Northdale Blvd Ste 150
Tampa, FL 33624-1871
Phone (813) 961-1331

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
I20190205003137 FL Practitioner - General Surgery 0547240400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wazni PLLCGroup PAC ID 2860629466, 30 clinicians

Practice addresses (Care Compare)

3003 S Florida Ave
Suite 101
Lakeland, FL 33803-4050
Phone (800) 991-6117

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal734

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG009192MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Specialty Group LLC Surgery CurrentSince Mar 1, 2004 Accepting new patients
Wazni, PLLC Surgery CurrentSince Jan 1, 2020 Accepting new patients
Colorado Medical Group, PLLC Surgery Past Accepting new patients
Carolina Mountain Internal Medicine PastSince Mar 21, 2021 Accepting new patients
Robert L Marchese MD Diseases of the Lung PLLC PastSince Oct 29, 2005 Accepting new patients

Locations

18167 US Highway 19 N
Ste 100
Clearwater, FL 33764
Phone (727) 233-4177

3003 S Florida Ave
Ste 101
Lakeland, FL 33803
Phone (863) 687-8990

4619 Little Rd
New Pt Richey, FL 34655
Phone (727) 372-9918

295 NW Peacock Blvd
Port St Lucie, FL 34986

3810 Northdale Blvd
Ste 260
Tampa, FL 33624

3810 Northdale Blvd
Ste 150
Tampa, FL 33624
Phone (813) 683-4784

3657 Madaca Ln
Tampa, FL 33618

3609 Madaca Ln
Tampa, FL 33618
Phone (720) 253-3071

3820 Northdale Blvd
Ste 201
Tampa, FL 33624

8029 Cooper Creek Blvd
Ste 104
University Park, FL 34201

4700 N Congress Ave
Ste 301
West Palm Beach, FL 33407
Phone (561) 594-1840

16553 S US Highway 301
Wimauma, FL 33598

16151 19 Mile Rd
Ste 301
Clinton Twp, MI 48038
Phone (586) 203-1790

25810 Kelly Rd
Ste 3
Roseville, MI 48066
Phone (586) 541-8419

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: andrew.georgeson@uvvc.eclinicaldirectplus.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1922017938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 NORTHDALE BLVD STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241871",
            "telephone_number": "813-961-1331",
            "fax_number": "888-850-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N CONGRESS AVE STE 301",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073292",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGESON",
        "first_name": "ANDREW",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "AG009192",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS14725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.