Individual provider Active NPI

Adamantia Anna Mammas, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Orlando, FL
National Provider Identifier
1093822629
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
ME55533 Issued in FL
Practice address
5900 S John Young Pkwy
Orlando, FL 32839-3716
Phone
(407) 398-6470
NPI assigned
Aug 23, 2006
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X ME55533 FL Primary

Addresses

Primary practice location

5900 S John Young Pkwy
Orlando, FL 32839-3716

Mailing address

3219 S Highway A1A
Melbourne Beach, FL 32951-3432
Phone (407) 455-0829

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
I20100430000205 FL Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 4981731551 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Emergency Physicians Kang and Associates MD LLC CurrentSince Feb 1, 2018 Accepting new patients
Night Lite Pediatric Center, LLC PastSince Dec 21, 2021 Accepting new patients
Night Lite Pediatric Center, LLC Past Accepting new patients
Night Lite Pediatric Center, LLC PastSince Dec 21, 2021 Accepting new patients
Night Lite Pediatric Center, LLC PastSince Dec 21, 2021 Accepting new patients
Night Lite Pediatric Center, LLC PastSince Dec 21, 2021 Accepting new patients
Night Lite Pediatric Center, LLC PastSince Dec 21, 2021 Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

7727 Lk Under Hl
Orlando, FL 32822
Phone (407) 303-6413

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 8

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1093822629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3219 S HIGHWAY A1A",
            "city": "MELBOURNE BEACH",
            "state": "FL",
            "postal_code": "329513432",
            "telephone_number": "407-455-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 S JOHN YOUNG PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328393716",
            "telephone_number": "407-398-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMAS",
        "first_name": "ADAMANTIA",
        "middle_name": "ANNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME55533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.