Individual provider Active NPI

Kimmai Magali Lonsdorfer, PA

  • Physician Assistant
  • Oviedo, FL
National Provider Identifier
1023115813
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101310 Issued in FL
Practice address
968 W Mitchell Hammock Rd Ste 1050
Oviedo, FL 32765-8123
Phone
(407) 890-1890
NPI assigned
Sep 20, 2006
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9101310 FL Primary

Addresses

Primary practice location

968 W Mitchell Hammock Rd Ste 1050
Oviedo, FL 32765-8123

Mailing address

1849 Walker Ave
Winter Park, FL 32789-3980
Phone (407) 463-0193

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090407000549 FL Practitioner - Physician Assistant 0648327783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carespot of Orlando Hsi Urgent Care LLCGroup PAC ID 8921372558, 55 clinicians

Practice addresses (Care Compare)

2323 S Orange Ave a
Carespot Urgent Care
Orlando, FL 32806-3059
Phone (407) 418-9999

2555 S Kirkman Rd
Carespot Urgent Care
Orlando, FL 32811-2346
Phone (407) 362-2030

3840 State Rd
436 Suite 1000
Apopka, FL 32703-6041
Phone (615) 600-4074

5355 Red Bug Lake Rd
Winter Springs, FL 32708-4909
Phone (321) 304-3300

7751 Kingspointe Pkwy
Suite 114
Orlando, FL 32819-6502
Phone (407) 581-9672

968 W Mitchell Hammock Rd
1050 Carespot Urgent Care
Oviedo, FL 32765-8123
Phone (407) 890-1890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9101310FLMDPhysician Assistant

Networks

  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1023115813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 WALKER AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893980",
            "telephone_number": "407-463-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 W MITCHELL HAMMOCK RD STE 1050",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658123",
            "telephone_number": "407-890-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONSDORFER",
        "first_name": "KIMMAI",
        "middle_name": "MAGALI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.