NPIMap

Organization Active NPI

Lake Pulmonary & Sleep Disorders Clinic P.a.

  • Pulmonary Disease Physician
  • Leesburg, FL
National Provider Identifier
1962497545
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
0041828 Issued in FL
Legal business name
LAKE PULMONARY & SLEEP DISORDERS CLINIC P.A.
Practice address
501 Medical Plaza Dr
Suite 102
Leesburg, FL 34748-7324
Phone
(352) 728-0709
Fax
(352) 728-6460
NPI assigned
Sep 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Authorized official

Name
Dr. Felipe O Ortiz, MDNPI 1811989569
Title
President
Phone
(352) 728-0709

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X 0041828 FL Primary

Addresses

Primary practice location

501 Medical Plaza Dr
Suite 102
Leesburg, FL 34748-7324

Mailing address

501 Medical Plaza Dr
Suite 102
Leesburg, FL 34748-7324
Phone (352) 728-0709

Other identifiers 2

IdentifierTypeStateIssuer
253650100MedicaidFL
21618OtherFLBLUE SHIELD

Other names 1

  • Humberto R. Delgado MD, PA Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060110000813 FL Part B Supplier - Clinic/Group Practice 9931122561 Receives reassigned benefits from 13 practitioners
Practice locations: Leesburg, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0992860Lake Pulmonary & Sleep Disorders Clinic PA501 Medical Plaza Dr #102, Leesburg, FL 34748Certificate of waiverOct 28, 2027

National Provider Directory

National Provider Directory

Locations

501 Medical Plaza Dr
Ste 102
Leesburg, FL 34748
Phone (352) 315-1627

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435190400000",
    "number": "1962497545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MEDICAL PLAZA DR",
            "address_2": "SUITE 102",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487324",
            "telephone_number": "352-728-0709",
            "fax_number": "352-728-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MEDICAL PLAZA DR",
            "address_2": "SUITE 102",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487324",
            "telephone_number": "352-728-0709",
            "fax_number": "352-728-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PULMONARY & SLEEP DISORDERS CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2015-06-25",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "FELIPE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-728-0709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "0041828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253650100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "21618",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humberto R. Delgado MD, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.