Individual provider Active NPI

Maria Carlota Sanjorge, M.D.

  • Pediatrics Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1992863740
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 49290 Issued in FL
Practice address
2560 Rca Blvd Ste 113
Palm Beach Gardens, FL 33410-3337
Phone
(561) 626-5790
Fax
(561) 626-6205
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 49290 FL Primary

Addresses

Primary practice location

2560 Rca Blvd Ste 113
Palm Beach Gardens, FL 33410-3337

Mailing address

1070 Siena Oaks Cir E
Palm Beach Gardens, FL 33410-5134
Phone (561) 627-1442

Other identifiers 1

IdentifierTypeStateIssuer
003050900MedicaidFL

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
I20110215000796 FL Practitioner - Pediatric Medicine 9830379353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 49290FLMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1992863740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 SIENA OAKS CIR E",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334105134",
            "telephone_number": "561-627-1442",
            "fax_number": "561-626-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 RCA BLVD STE 113",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103337",
            "telephone_number": "561-626-5790",
            "fax_number": "561-626-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANJORGE",
        "first_name": "MARIA",
        "middle_name": "CARLOTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 49290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003050900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.