Individual provider Active NPI

Tanweer A Memon, M.D.

  • Internal Medicine Physician
  • Port Charlotte, FL
National Provider Identifier
1053304774
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0074367 Issued in FL
Practice address
2852 Tamiami TRL Ste 5
Port Charlotte, FL 33952-5100
Phone
(941) 625-9494
Fax
(941) 743-8562
NPI assigned
Aug 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 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 ME0074367 FL Primary

Addresses

Primary practice location

2852 Tamiami TRL Ste 5
Port Charlotte, FL 33952-5100

Mailing address

2852 Tamiami TRL Ste 5
Port Charlotte, FL 33952-5100
Phone (941) 625-9494

Other identifiers 4

IdentifierTypeStateIssuer
117689400MedicaidFL
5236702OtherFLAETNA
258993100MedicaidFL
42648OtherFLBCBS

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
I20041221000737 FL Practitioner - Internal MedicinePractitioner - Pain ManagementPractitioner - Peripheral Vascular Disease 8224096359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pain Management, Peripheral Vascular Disease
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2852 Tamiami TRL
Suite 5
Port Charlotte, FL 33952-5100
Phone (941) 625-9494

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Port Charlotte, FL, CCN 108270
  • Coastal Breeze Home Health LLC Home health agency, Sarasota, FL, CCN 687159
  • Haven Home Health Care Home health agency, Venice, FL, CCN 687116
  • Adventhealth Port Charlotte Hospital, Port Charlotte, FL, CCN 100077
  • Desoto Memorial Hospital Hospital, Arcadia, FL, CCN 100175

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal27
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0074367FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanweer Memon MD PA Internal Medicine CurrentSince Jun 1, 2006 Accepting new patients

Locations

14243 Tamiami Trl
North Port, FL 34287
Phone (941) 429-3180

2091 Tamiami Trl
Pt Charlotte, FL 33948
Phone (941) 625-9494

2852 Tamiami Trl
Ste 5
Pt Charlotte, FL 33952
Phone (941) 625-4442

Interoperability endpoints

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

Organizations & group practices 1

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 5

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": "1125187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1053304774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 TAMIAMI TRL STE 5",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525100",
            "telephone_number": "941-625-9494",
            "fax_number": "941-743-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 TAMIAMI TRL STE 5",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525100",
            "telephone_number": "941-625-9494",
            "fax_number": "941-743-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMON",
        "first_name": "TANWEER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-28",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0074367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117689400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5236702",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258993100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "42648",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.