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CENTERWELL SENIOR PRIMARY CARE VITALITY INC
NPI 1154293108
Internal Medicine in The Villages, FL

Active since September 19, 2025CLIA Certified · 2 labs
779 KRISTINE WAY, THE VILLAGES, FL 32163(352) 674-6020(352) 674-6030 Get Directions Write a Review

NPPES record last updated: September 19, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Centerwell Senior Primary Care Vitality Inc NPPES

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

CENTERWELL SENIOR PRIMARY CARE VITALITY INC (NPI 1154293108) is a healthcare organization registered as an internal medicine in The Villages, Florida and active in the NPI registry since September 2025. The organization holds 2 active CLIA laboratory certificates and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1154293108
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE VITALITY INC
Location Address779 KRISTINE WAYThe Villages, FL 32163-0099
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (407) 447-7120
Phone(352) 674-6020
Fax(352) 674-6030
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateSeptember 19, 2025
NPPES CertifiedSeptember 19, 2025
✔ NPI 1154293108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
779 KRISTINE WAY, The Villages, FL 32163
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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Centerwell Senior Primary Care Vitality Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

167

Medicare enrollment records show 167 clinicians reassign Medicare billing to Centerwell Senior Primary Care Vitality Inc, which bills Medicare for the services they deliver. Of these, 12 practice at this address and 133 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 19

Nurse Practitioner60
Family Practice34
Internal Medicine27
Qualified Audiologist6
Cardiovascular Disease (Cardiology)4
Endocrinology4
Neurology4
Registered Dietitian or Nutrition Professional4
11 other specialties24

Nearest to this location (20)

See all 167
Victor Flores, M.D.
Family Practice
NPI 1760790661
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Ronald Grose, M.D.
Family Practice
NPI 1699743310
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Ujjwala Jain, MD
Internal Medicine
NPI 1013598978
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Swati Joshi, D.O
Internal Medicine
NPI 1144566001
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Greg Jun, MD
Internal Medicine
NPI 1043212780
779 KRISTINE WAY
The Villages, FL 32163
(352) 674-6020
✔ PECOS✔ Accepts MedicareSame address
Joanne Kitson, MD
Internal Medicine
NPI 1124092374
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Lacey Myers, APRN
Nurse Practitioner
NPI 1063001832
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Lakshmidevi Persaud, APRN
Nurse Practitioner
NPI 1629755772
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Kayla Phillips
Nurse Practitioner
NPI 1831852235
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Brooke Thermidor, DO
Family Practice
NPI 1083787675
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Phuong Thi Tran, D.O.
Family Practice
NPI 1164422267
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Alyssa Verkuilen, DNP
Nurse Practitioner
NPI 1144862459
779 KRISTINE WAY
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts MedicareSame address
Sondra Griggs, DNP
Nurse Practitioner
NPI 1942155635
280 FARNER PL
The Villages, FL 32163
(352) 674-1710
✔ PECOS2.8 mi
Brooks Betts, DO
Family Practice
NPI 1982653325
280 FARNER PLACE
The Villages, FL 32163
(352) 674-1710
✔ PECOS✔ Accepts Medicare2.8 mi
Sara Gosik, RD
Registered Dietitian or Nutrition Professional
NPI 1891299368
280 FARNER PL
The Villages, FL 32163
(844) 884-9355
✔ Accepts Medicare2.8 mi
Harsha Rajashekar, D.O.
Interventional Pain Management
NPI 1760668164
2910 BROWNWOOD BLVD
The Villages, FL 32163
(352) 674-8700
✔ PECOS✔ Accepts Medicare3.8 mi
Leonard Ranasinghe, MD
Internal Medicine
NPI 1295813780
2910 BROWNWOOD BLVD
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts Medicare3.8 mi
Catherine Sullivan, MD
Rheumatology
NPI 1548256100
2910 BROWNWOOD BLVD
The Villages, FL 32163
(352) 674-8700
✔ PECOS✔ Accepts Medicare3.8 mi
Joan Jones, PH.D
Mental Health Counselor
NPI 1447648340
2485 PINELLAS PL
The Villages, FL 32163
(844) 884-9355
✔ PECOS3.8 mi
Desiree Casasnovas-Lopez, M.D.
Neurology
NPI 1851596738
2955 BROWNWOOD BLVD
The Villages, FL 32163
(844) 884-9355
✔ PECOS✔ Accepts Medicare4.0 mi
See all 167 clinicians

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 2

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 10D2224285

Centerwell Senior Primary Care (vitality), Inc Dba Centerwell Senior Primary Care · The Villages, FL
Active · expires May 11, 2027
CLIA Number10D2224285
Laboratory TypePhysician Office
Certificate Effective DateMay 12, 2025
Certificate Expiration DateMay 11, 2027
Laboratory DirectorGreg Jun
Laboratory Phone(352) 674-6020
Laboratory LocationCenterwell Senior Primary Care (vitality), Inc Dba Centerwell Senior Primary Care779 Kristine Way, The Villages, FL 32163
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2052051

Centerwell Senior Primary Care (vitality), Inc Dba Centerwell Senior Primary Care · The Villages, FL
Active · expires Jan 3, 2027
CLIA Number10D2052051
Laboratory TypePhysician Office
Certificate Effective DateJanuary 4, 2025
Certificate Expiration DateJanuary 3, 2027
Laboratory DirectorJulie Sudduth
Laboratory Phone(352) 674-8819
Laboratory LocationCenterwell Senior Primary Care (vitality), Inc Dba Centerwell Senior Primary Care2485 Pinellas Place, The Villages, FL 32163
CLIA data matches this NPI record on: Name
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 Centerwell Senior Primary Care Vitality Inc's NPI number?

The NPI number for Centerwell Senior Primary Care Vitality Inc is 1154293108. It was assigned to this organization in the NPPES registry on September 19, 2025.

Where is Centerwell Senior Primary Care Vitality Inc located?

Centerwell Senior Primary Care Vitality Inc is located at 779 Kristine Way, The Villages, FL 32163. The listed phone number is (352) 674-6020.

What is Centerwell Senior Primary Care Vitality Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Centerwell Senior Primary Care Vitality Inc enrolled in Medicare?

Yes. Centerwell Senior Primary Care Vitality Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Centerwell Senior Primary Care Vitality Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 167 clinicians in 19 Medicare specialties reassign their Medicare billing to Centerwell Senior Primary Care Vitality Inc. 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. The largest specialties are Nurse Practitioner (60), Family Practice (34) and Internal Medicine (27). Of these, 12 practice at this address and 133 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Centerwell Senior Primary Care Vitality Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Centerwell Senior Primary Care Vitality Inc accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Centerwell Senior Primary Care Vitality Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care Vitality Inc was last updated on September 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.