Individual provider Active NPI

Amir Hesam Etemadnia, M.D.

  • Internal Medicine Physician
  • Ocoee, FL
National Provider Identifier
1003115098
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 109667 Issued in FL
Practice address
10125 W Colonial Dr Ste 101
Ocoee, FL 34761-4212
Phone
(407) 777-2503
Fax
(407) 777-2523
NPI assigned
Mar 16, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 109667 FL Primary

Addresses

Primary practice location

10125 W Colonial Dr Ste 101
Ocoee, FL 34761-4212

Mailing address

2418 Chelsea St
Orlando, FL 32803-2124
Phone (718) 715-9244

Other practice location 1

1401 Roosevelt Ave
York, PA 17404-2244
Phone (877) 232-5807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MN, PA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20111026000649 FL Practitioner - Internal Medicine 0749453330 Reassigns benefits to 1 organization
I20250904002130 MN Practitioner - Internal Medicine 0749453330 Reassigns benefits to 1 organization
I20251001003697 PA Practitioner - Internal Medicine 0749453330

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10125 W Colonial Dr
Suite 101
Ocoee, FL 34761-4212
Phone (407) 777-2503

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 109667FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 25, 2025 Accepting new patients
All About Medicine LLC Internal Medicine CurrentSince Apr 8, 2025 Accepting new patients
Allina Health System CurrentSince Aug 25, 2025 Accepting new patients
Mid-Florida Dermatology Associates P.a. PastSince Apr 8, 2025 Accepting new patients

Locations

10125 W Colonial Dr
Ste 101
Ocoee, FL 34761
Phone (407) 777-2503

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

Networks

  • FL HMO C-SNP
  • FL PPO
  • FL HMO D-SNP
  • Freedom Health HMO Network
  • FL HMO
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EABIDD/Endpoint/EABIDD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1003115098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 CHELSEA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328032124",
            "telephone_number": "718-715-9244",
            "fax_number": "407-777-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10125 W COLONIAL DR STE 101",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614212",
            "telephone_number": "407-777-2503",
            "fax_number": "407-777-2523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Roosevelt Ave",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174042244",
            "country_code": "US",
            "telephone_number": "877-232-5807",
            "fax_number": "407-777-2523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETEMADNIA",
        "first_name": "AMIR",
        "middle_name": "HESAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-16",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 109667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.