Dr Keron Alicia Ferguson, MD is a medicare enrolled "Preventive Medicine - Undersea And Hyperbaric Medicine" physician in Maitland, Florida. She graduated from medical school in 2003 and has 23 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Kopa Llc, House Call M.d.'s L.l.c and her current practice location is
2400 Maitland Center Pkwy Ste 310, Maitland, Florida. You can reach out to her office (for appointments etc.) via phone at
(407) 426-4800.
Dr Keron Alicia Ferguson is licensed to practice in Florida (license number ME94429) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1215007125.
Physician's Profile
| Full Name | Dr Keron Alicia Ferguson |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 23 Years |
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| Location | 2400 Maitland Center Pkwy Ste 310, Maitland, Florida |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Keron Alicia Ferguson graduated from medical school in 2003
NPI Data:
- NPI Number: 1215007125
- Provider Enumeration Date: 11/08/2006
- Last Update Date: 04/02/2025
Medicare PECOS Information:
- PECOS PAC ID: 4284725565
- Enrollment ID: I20070801000657
Medical Identifiers
Medical identifiers for Dr Keron Alicia Ferguson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1215007125 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | ME94429 (Florida) | Secondary |
| 208D00000X | General Practice | ME94429 (Florida) | Secondary |
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | ME94429 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Kopa Llc | 5193774461 | 27 |
| House Call M.d.'s L.l.c | 5496033839 | 15 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Keron Alicia Ferguson allows following entities to bill medicare on her behalf.
| Entity Name | Nautilus Health Care Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912013558
PECOS PAC ID: 5991604852
Enrollment ID: O20040108000803 |
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| Entity Name | Kopa Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1417021114
PECOS PAC ID: 5193774461
Enrollment ID: O20050113001021 |
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| Entity Name | House Call M.d.'s L.l.c |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275955312
PECOS PAC ID: 5496033839
Enrollment ID: O20161105000102 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Keron Alicia Ferguson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Keron Alicia Ferguson, MD
222 Broadway Suite 301, Attn: Credentialing,
Kissimmee, FL 34741
Ph: (407) 846-8180 | Dr Keron Alicia Ferguson, MD
2400 Maitland Center Pkwy Ste 310,
Maitland, FL 32751-7442
Ph: (407) 426-4800 |
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