Centerwell Senior Primary Care KS PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CENTERWELL SENIOR PRIMARY CARE KS PA

Practice address

4700 Millenia Blvd Ste 650
Orlando, FL 32839-6013

Phone

(407) 447-7120

NPI assigned

Apr 21, 2020

Last updated

Aug 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angie Martinez

Title

Senior Credentialing Professional

Phone

(407) 447-7120

Specialties & licenses 3

Addresses

Other names 1

• Partners in Primary Care (KS), P.A. Former legal business name

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Centerwell Senior Primary Care KS PA

  dba CenterWell Senior Primary Care -Olathe

  • Internal Medicine Physician
  • Olathe, KS
  • NPI 1013438654

  O20200721000723

  Same enrollment
• Centerwell Senior Primary Care KS PA

  dba CenterWell Senior Primary Care (KS) PA - Parklane

  • Internal Medicine Physician
  • Wichita, KS
  • NPI 1013737576

  O20200721000723

  Same enrollment
• Centerwell Senior Primary Care KS PA

  dba CenterWell Senior Primary Care- State Avenue

  • Internal Medicine Physician
  • Kansas City, KS
  • NPI 1104347756

  O20200721000723

  Same enrollment
• Centerwell Senior Primary Care KS PA

  dba CenterWell Senior Primary Care KS PA - E 13th Street

  • Internal Medicine Physician
  • Wichita, KS
  • NPI 1215757778

  O20200721000723

  Same enrollment
• Centerwell Senior Primary Care KS PA

  dba Partners in Primary Care- Overland Park

  • Internal Medicine Physician
  • Overland Park, KS
  • NPI 1982257911

  O20200721000723

  Same enrollment

Locations

Practitioners 3

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.

• Jared Loran Johnson, MD

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1245435452
  NPD
• Amanda Nicole Stanley, APRN

  • Gerontology Nurse Practitioner
  • Kansas City, KS
  • NPI 1346946639
  NPD
• Saddad Zafar Toor, MD

  • Cardiovascular Disease Physician
  • Wayne, NJ
  • NPI 1649253998

  Internal Medicine

  NPD

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1972123875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MILLENIA BLVD STE 650",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328396013",
            "telephone_number": "407-447-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERWELL SENIOR PRIMARY CARE KS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "SENIOR CREDENTIALING PROFESSIONAL",
        "authorized_official_telephone_number": "407-447-7120"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Partners in Primary Care (KS), P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Centerwell Senior Primary Care NC JV PC
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• Internal Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.