Individual provider Active NPI

Jeremy Marcus Drake, M.D.

  • Colon & Rectal Surgery Physician
  • Kissimmee, FL
National Provider Identifier
1922398445
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
ME126634 Issued in FL
Practice address
2400 N Orange Blossom TRL Ste 200
Kissimmee, FL 34744-2307
Phone
(407) 303-5191
NPI assigned
Apr 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X ME126634 FL
Colon & Rectal Surgery Physician 208C00000X ME126634 FL Primary

Addresses

Primary practice location

2400 N Orange Blossom TRL Ste 200
Kissimmee, FL 34744-2307

Mailing address

2400 N Orange Blossom TRL
Kissimmee, FL 34744-2306
Phone (407) 303-2615

Other practice location 1

110 W Underwood St
Suite A
Orlando, FL 32806-1139
Phone (407) 422-3790

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
I20171016001841 FL Practitioner - Colorectal Surgery (Proctology) 7315184983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
University of Alabama School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050

2100 Ocoee Apopka Rd
Apopka, FL 32703-9210

2400 N Orange Blossom TRL
Kissimmee, FL 34744-2307

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

40100 Hwy 27
Davenport, FL 33837-5906
Phone (863) 422-4971

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME126634FLMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 5, 2017 Accepting new patients
Florida Hospital Medical Group Inc Colon & Rectal Surgery CurrentSince Sep 5, 2017 Accepting new patients

Locations

2400 N Orange Blossom Trl
Ste 200
Kissimmee, FL 34744
Phone (407) 303-5191

2400 N Orange Blossom Trl
Ste 203
Kissimmee, FL 34744
Phone (407) 932-6204

410 Celebration Pl
Ste 106
Kissimmee, FL 34747
Phone (407) 303-4829

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2415 N Orange Ave
Ste 300
Orlando, FL 32804
Phone (407) 303-2780

2000 Fowler Grove Blvd
Fl 3
Winter Garden, FL 34787
Phone (407) 521-3600

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jdrake56773@adventhealth.direct-ci.com

Organizations & group practices 2

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 3

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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922398445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442306",
            "telephone_number": "407-303-2615",
            "fax_number": "407-303-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL STE 200",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442307",
            "telephone_number": "407-303-5191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 W Underwood St",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061139",
            "country_code": "US",
            "telephone_number": "407-422-3790",
            "fax_number": "407-851-5058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "JEREMY",
        "middle_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "ME126634",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME126634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.