POINCIANA MEDICAL CLINIC
NPI 1871923037
General Practice in Kissimmee, FL
About Poinciana Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
POINCIANA MEDICAL CLINIC (NPI 1871923037) is a healthcare organization registered as a general practice in Kissimmee, Florida and active in the NPI registry since November 2013. The organization holds a CLIA Waiver certificate valid through March 16, 2028 and lists Ivan A Rivera Soler, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Poinciana Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Poinciana Medical Clinic, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (5)
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 10D2074820
Poinciana Medical Clinic · Kissimmee, FLFrequently 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 Poinciana Medical Clinic's NPI number?
The NPI number for Poinciana Medical Clinic is 1871923037. It was assigned to this organization in the NPPES registry on November 25, 2013.
Where is Poinciana Medical Clinic located?
Poinciana Medical Clinic is located at 51 N Doverplum Ave, Kissimmee, FL 34758. The listed phone number is (407) 572-8862.
What is Poinciana Medical Clinic's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Poinciana Medical Clinic enrolled in Medicare?
Yes. Poinciana Medical Clinic is registered in the Medicare PECOS enrollment system.
When is Poinciana Medical Clinic's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Poinciana Medical Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Poinciana Medical Clinic. 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 (3) and General Practice (2). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Poinciana Medical Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2074820) is associated with this NPI, valid through March 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Poinciana Medical Clinic accept?
Health plans from Ambetter Health, Ambetter of Alabama, Molina Healthcare and Wellpoint list Poinciana Medical Clinic 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 Poinciana Medical Clinic was last updated on July 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Poinciana Medical Clinic · NPI 1871923037
General Practice organization in Kissimmee, Florida. Organization record, active in the CMS NPPES registry since November 25, 2013.
## Identity
- **NPI:** 1871923037 (Entity type: Organization)
- **Enumerated:** November 25, 2013
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Organization subpart:** No
- **Authorized official:** Ivan Rivera Soler, MD
## Practice location
- **Address:** 51 N DOVERPLUM AVE, Kissimmee, FL 34758-3308
- **Phone:** (407) 572-8862 · **Fax:** (407) 572-8863
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 5 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), General Practice (2); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 21, 2014
- **Other identifiers:** Medicare UPIN CO009X (FL); Medicaid 001456400 (FL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1871923037) · Data from the CMS NPPES public registry.