Individual provider Active NPI

Mafaz Choudhary, DO

  • Family Medicine Physician
  • Winter Haven, FL
National Provider Identifier
1073188066
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS21138 Issued in FL
Practice address
7599 Cypress Gardens Blvd Ste P
Winter Haven, FL 33884-3263
Phone
(863) 324-4725
Fax
(863) 324-4783
NPI assigned
May 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS21138 FL Primary

Addresses

Primary practice location

7599 Cypress Gardens Blvd Ste P
Winter Haven, FL 33884-3263

Mailing address

7599 Cypress Gardens Blvd Ste P
Winter Haven, FL 33884-3263
Phone (863) 324-4725

Other practice location 1

1271 NW 143rd Ave
Pembroke Pines, FL 33028-2910
Phone (954) 383-5144

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
I20240829001514 FL Practitioner - Family Practice 2567901952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

Hospital & facility affiliations

  • Baycare Home Care Inc Home health agency, Lakeland, FL, CCN 107282
  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS21138FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine Current Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Aug 22, 2024 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

7599 Cypress Gardens Blvd
Winter Haven, FL 33884
Phone (863) 324-4725

7599 Cypress Gardens Blvd
Ste P
Winter Haven, FL 33884
Phone (863) 324-4725

Interoperability endpoints

  • Direct secure messaging: mafaz.choudhary@direct.mybaycare.org

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.

Hospital & facility affiliations 3

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": "1621728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1073188066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7599 CYPRESS GARDENS BLVD STE P",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843263",
            "telephone_number": "863-324-4725",
            "fax_number": "863-324-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7599 CYPRESS GARDENS BLVD STE P",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843263",
            "telephone_number": "863-324-4725",
            "fax_number": "863-324-4783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1271 NW 143rd Ave",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330282910",
            "country_code": "US",
            "telephone_number": "954-383-5144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOUDHARY",
        "first_name": "MAFAZ",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-23",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS21138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.