Individual provider Active NPI

Jose Luis Rosado II, MD

  • Family Medicine Physician
  • Deland, FL
National Provider Identifier
1972719292
Registry record updated Sep 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME99512 Issued in FL
Practice address
701 W Plymouth Ave
Deland, FL 32720-3236
Phone
(386) 943-4522
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME99512 FL Primary

Addresses

Primary practice location

701 W Plymouth Ave
Deland, FL 32720-3236

Mailing address

PO Box 9430
Daytona Beach, FL 32120-9430
Phone (386) 274-7800

Other identifiers 2

IdentifierTypeStateIssuer
280587100MedicaidFL
23661OtherFLBCBS

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
I20080419000037 FL Practitioner - Family PracticePractitioner - Emergency Medicine 8224116033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Professionals PA CurrentSince Jul 1, 2009 Accepting new patients
Halifax Healthcare Systems Inc Family Medicine CurrentSince Mar 28, 2017 Accepting new patients
Bay View Urgent Care LLC Family Medicine PastSince Apr 1, 2010 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

201 N Clyde Morris Blvd
Ste 230
Daytona Beach, FL 32114
Phone (386) 226-4537

701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Adventhealth New Smyrna BeachNew Smyrna Beach, FL, CCN 100014 Hospital Corporate Director Dec 12, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252022400000",
    "number": "1972719292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9430",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209430",
            "telephone_number": "386-274-7800",
            "fax_number": "386-274-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203236",
            "telephone_number": "386-943-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2009-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME99512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280587100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "23661",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.