Orlando Sports Medicine Group Inc - Medicare Primary Care in Orlando, FL

Orlando Sports Medicine Group Inc is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Orlando, Florida. The current practice location for Orlando Sports Medicine Group Inc is 12780 Waterford Lakes Pkwy, Suite 115, Orlando, Florida. For appointments, you can reach them via phone at (407) 207-7188. The mailing address for Orlando Sports Medicine Group Inc is 12780 Waterford Lakes Pkwy, Suite 115, Orlando, Florida and phone number is (407) 207-7188.

Orlando Sports Medicine Group Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1023129178. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (407) 207-7188.

Contact Information

Orlando Sports Medicine Group Inc
12780 Waterford Lakes Pkwy
Suite 115
Orlando
FL 32828-4500
(407) 207-7188
(407) 207-7103

Primary Care Clinic Profile

Full NameOrlando Sports Medicine Group Inc
SpecialityClinic/Center
Location12780 Waterford Lakes Pkwy, Orlando, Florida
Authorized Official Name and PositionEric Greeno (PRESIDENT)
Authorized Official Contact4072077188
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Orlando Sports Medicine Group Inc
12780 Waterford Lakes Pkwy
Suite 115
Orlando
FL 32828-4500

Ph: (407) 207-7188
Orlando Sports Medicine Group Inc
12780 Waterford Lakes Pkwy
Suite 115
Orlando
FL 32828-4500

Ph: (407) 207-7188

NPI Details:

NPI Number1023129178
Provider Enumeration Date08/31/2006
Last Update Date08/19/2008

Medicare PECOS Information:

Medicare PECOS PAC ID0840225785
Medicare Enrollment IDO20141222000499

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Medical Identifiers

Medical identifiers for Orlando Sports Medicine Group Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023129178NPI-NPPES
Y902TOtherFLBLUE CROSS BLUE SHIELD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Orlando Sports Medicine Group Inc acts as a billing entity for following providers:
Provider NameEric D Greeno
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1669574331
PECOS PAC ID: 3375578214
Enrollment ID: I20050930000080

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Provider IdentifiersNPI Number: 1053661355
PECOS PAC ID: 5799008884
Enrollment ID: I20141222000871

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Provider IdentifiersNPI Number: 1336628924
PECOS PAC ID: 2769726744
Enrollment ID: I20181203000025

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PECOS PAC ID: 1153753025
Enrollment ID: I20191114000850

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