Tanam Ahmed, MD
Individual provider Active NPI Family Medicine Physician · Palm Coast, FL
NPI 1043475155 · NPPES record last updated Jan 8, 2013
Key facts
- NPI
- 1043475155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME109737 (FL)
- Practice address
- 120 Cypress Edge Dr
Suite 207
Palm Coast, FL 32164-8453 - Phone
- (386) 586-4390
- Fax
- (386) 586-4392
- NPI assigned
- Jul 29, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 7
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Adventhealth Primary Care Network Inc
Practice addresses (Care Compare)
661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040
Hospital & facility affiliations
- Trilogy Home Healthcare
- Bravery Home Healthcare
- Adventhealth Home Health
- AdventHealth Palm Coast
- Adventhealth Palm Coast Parkway
- Adventhealth Daytona Beach
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Adventhealth Palm Coast |
Hospital | Corporate Director | Jan 1, 2026 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111214001004 | FL | Practitioner - Family Practice | 5890960157 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT193279 | PA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventhealth Primary Care Network Inc | Family Medicine | Current |
Accepting new patients |
Locations
661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040
120 Cypress Edge Dr
Ste 102
Palm Coast, FL 32164
Phone (386) 586-4280
120 Cypress Edge Dr
Ste 203
Palm Coast, FL 32164
Phone (386) 586-4390
120 Cypress Edge Dr
Ste 210
Palm Coast, FL 32164
Phone (386) 445-4750
Interoperability endpoints
- tahmed59044@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MT193279 | PA | |
| Family Medicine Physician | 207Q00000X | ME109737 | FL | Yes |
Addresses
Primary practice location
120 Cypress Edge Dr
Suite 207
Palm Coast, FL 32164-8453
Mailing address
120 Cypress Edge Dr
Suite 207
Palm Coast, FL 32164-8453
Phone (386) 586-4390
Other providers in Palm Coast, FL
- Affordable Dentures & Implants - Palm Coast, P.a.
- Affordable Health Center Inc
- Roz Aghaaliandastjerdi
- Jennifer Marie Agosto
- Sarai Aguiar Ugalde
- Oluwatosin Adesola Ajayi
- Alan Medina, MD PA
- David F. Alaniz
- Ahmad Samer Alawad
- Albertsons LLC
All providers in Palm Coast, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.