Organization Active NPI

Urgent Care Center of Longwood LLC

  • Urgent Care Clinic/Center
  • Longwood, FL
National Provider Identifier
1093905986
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
URGENT CARE CENTER OF LONGWOOD LLC
Practice address
450 W State Road 434 Ste 1010
Longwood, FL 32750-5187
Phone
(407) 212-3000
Fax
(407) 212-3001
NPI assigned
Jul 27, 2007
Last updated
Aug 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Authorized official

Name
Dr. Wasim Ahmar, MDNPI 1528061330
Title
Owner
Phone
(407) 212-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X FL Primary

Addresses

Primary practice location

450 W State Road 434 Ste 1010
Longwood, FL 32750-5187

Mailing address

450 W State Road 434 Ste 1010
Longwood, FL 32750-5187
Phone (407) 212-3000

Other identifiers 1

IdentifierTypeStateIssuer
247855139OtherFLURGENT CARE-ACHA EXEMPT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180619000028 FL Part B Supplier - Clinic/Group Practice 0345595286 Receives reassigned benefits from 11 practitioners
Practice locations: Kissimmee, FL; Longwood, FL; Orlando, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2021781Urgent Care at Longwood450 W State Road 434 Ste 1010, Longwood, FL 32750Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Locations

7148 Curry Ford Rd
Ste 400
Orlando, FL 32822
Phone (407) 730-7850

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1093905986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W STATE ROAD 434 STE 1010",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505187",
            "telephone_number": "407-212-3000",
            "fax_number": "407-212-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W STATE ROAD 434 STE 1010",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505187",
            "telephone_number": "407-212-3000",
            "fax_number": "407-212-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE CENTER OF LONGWOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "AHMAR",
        "authorized_official_first_name": "WASIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-212-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "URGENT  CARE-ACHA EXEMPT",
            "identifier": "247855139",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.