Individual provider Active NPI

Rhoderick C Nazario, M.D.

  • Pulmonary Disease Physician
  • Kissimmee, FL
National Provider Identifier
1962466730
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
84666 Issued in FL
Practice address
1121 N Central Ave
Suite B
Kissimmee, FL 34741-4405
Phone
(407) 933-1221
Fax
(407) 933-0747
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 84666 FL Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 84666 FL

Addresses

Primary practice location

1121 N Central Ave
Suite B
Kissimmee, FL 34741-4405

Mailing address

1121 N Central Ave
Suite B
Kissimmee, FL 34741-4405
Phone (407) 933-1221

Other identifiers 6

IdentifierTypeStateIssuer
264756700MedicaidFL
3892967004OtherFLCIGNA PROVIDER ID
285149OtherFLAVMED PROVIDER ID
4800614OtherFLUHC PROVIDER ID
7728680OtherFLAETNA PROVIDER ID
17116OtherFLBLUE CROSS BLUE SHIELD

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
I20101104001028 FL Practitioner - Pulmonary Disease 5092909986 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84666FLMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Disease Specialists, PA Pulmonary Disease CurrentSince Jul 1, 2002 Accepting new patients
Ronaz Medical Management Pulmonary Disease Current Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 29, 2016 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 29, 2016 Accepting new patients

Locations

40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496

110 Park Place Blvd
Davenport, FL 33837
Phone (863) 419-0104

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

290 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 933-1221

1121 N Central Ave
Kissimmee, FL 34741
Phone (407) 933-1221

1121 N Central Ave
Ste B
Kissimmee, FL 34741
Phone (407) 933-1221

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

2250 Bedford Rd
Orlando, FL 32803
Phone (407) 303-1766

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1962466730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 N CENTRAL AVE",
            "address_2": "SUITE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414405",
            "telephone_number": "407-933-1221",
            "fax_number": "407-933-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 N CENTRAL AVE",
            "address_2": "SUITE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414405",
            "telephone_number": "407-933-1221",
            "fax_number": "407-933-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARIO",
        "first_name": "RHODERICK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "84666",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "84666",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264756700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER ID",
            "identifier": "3892967004",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED PROVIDER ID",
            "identifier": "285149",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PROVIDER ID",
            "identifier": "4800614",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "7728680",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "17116",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.