Individual provider Active NPI

Robin L Rahm, M.D.

  • Surgery Physician
  • Lake Mary, FL
National Provider Identifier
1003867862
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME74066 Issued in FL
Practice address
4106 W Lake Mary Blvd Ste 213
Lake Mary, FL 32746-2403
Phone
(407) 829-2020
Fax
(407) 829-2098
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME74066 FL Primary

Addresses

Primary practice location

4106 W Lake Mary Blvd Ste 213
Lake Mary, FL 32746-2403

Mailing address

4106 W Lake Mary Blvd Ste 213
Lake Mary, FL 32746-2403
Phone (407) 648-3800

Other identifiers 2

IdentifierTypeStateIssuer
104046200MedicaidFL
59-3654810OtherFLTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040628000796 FL Practitioner - General SurgeryPractitioner - Surgical Oncology 1658357884 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2019 Accepting new patients

Locations

4106 W Lake Mary Blvd
Ste 213
Lake Mary, FL 32746
Phone (321) 843-2100

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1400 S Orange Ave
Orlando, FL 32806
Phone (321) 841-1893

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1003867862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 W LAKE MARY BLVD STE 213",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462403",
            "telephone_number": "407-648-3800",
            "fax_number": "407-425-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 W LAKE MARY BLVD STE 213",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462403",
            "telephone_number": "407-829-2020",
            "fax_number": "407-829-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHM",
        "first_name": "ROBIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME74066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104046200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "59-3654810",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.