1. Home
  2. Directory
  3. Florida
  4. Orlando
  5. Internal Medicine
  6. NPI Profile

SUPREME MEDICAL GROUP PLLC
NPI 1073970810
Internal Medicine - Infectious Disease in Orlando, FL

Active since January 25, 2016CLIA 10D2174600 · Waiver
10967 LAKE UNDER HILL RD, UNIT 137, ORLANDO, FL 32825(407) 930-1030(407) 386-7277 Get Directions Write a Review

NPPES record last updated: December 23, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Dec 23, 2020, Aug 9, 2019, Mar 12, 2018 and 3 more (6 updates tracked since 2016).

About Supreme Medical Group Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPREME MEDICAL GROUP PLLC (NPI 1073970810) is a healthcare organization registered as an infectious disease in Orlando, Florida and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through November 4, 2027 and lists Sheena Mary Jose, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1073970810
Entity TypeOrganization
Primary Taxonomy207RI0200X
Legal Business NameSUPREME MEDICAL GROUP PLLC
Location Address10967 LAKE UNDER HILL RD, UNIT 137Orlando, FL 32825-4455
Mailing Address10967 Lake Under Hill Road, Unit 137Orlando, FL 32825-4455 · (407) 930-1030 · Fax (407) 386-7277
Phone(407) 930-1030
Fax(407) 386-7277
Organization SubpartNo
Authorized OfficialSheena Mary JoseMedical Director · (407) 930-1030
Enumeration DateJanuary 25, 2016
Last NPPES UpdateDecember 23, 20206 updates tracked since enumeration
NPPES CertifiedDecember 23, 2020
✔ NPI 1073970810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in FL · ME109765
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
10967 LAKE UNDER HILL RD, Orlando, FL 32825
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Supreme Medical Group Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Supreme Medical Group PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Sheena Jose, MD
Infectious Disease
NPI 1659307759
10967 LAKE UNDER HILL RD UNIT 137
Orlando, FL 32825
(407) 930-1030
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2174600

Supreme Medical Group PLLC · Orlando, FL
Active · expires Nov 4, 2027
CLIA Number10D2174600
Laboratory TypePhysician Office
Certificate Effective DateNovember 5, 2025
Certificate Expiration DateNovember 4, 2027
Laboratory DirectorSheena M. Jose
Laboratory Phone(407) 930-1030
Laboratory LocationSupreme Medical Group PLLC10967 Lake Underhill Rd Ste 137, Orlando, FL 32825
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Supreme Medical Group PLLC's NPI number?

The NPI number for Supreme Medical Group PLLC is 1073970810. It was assigned to this organization in the NPPES registry on January 25, 2016.

Where is Supreme Medical Group PLLC located?

Supreme Medical Group PLLC is located at 10967 Lake Under Hill Rd Unit 137, Orlando, FL 32825. The listed phone number is (407) 930-1030.

What is Supreme Medical Group PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Supreme Medical Group PLLC enrolled in Medicare?

Yes. Supreme Medical Group PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Supreme Medical Group PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Infectious Disease) reassigns their Medicare billing to Supreme Medical Group PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Supreme Medical Group PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2174600) is associated with this NPI, valid through November 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Supreme Medical Group PLLC was last updated on December 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.