NPIMap

Organization Active NPI

Ocala Infectious Disease and Wound Center, Inc

  • Infectious Disease Physician
  • Ocala, FL
National Provider Identifier
1093911935
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME88195 Issued in FL
Legal business name
OCALA INFECTIOUS DISEASE AND WOUND CENTER, INC
Practice address
321 SE 29TH PL
Suite 101
Ocala, FL 34471-0489
Phone
(352) 401-7552
Fax
(352) 622-7945
NPI assigned
Jun 26, 2007
Last updated
Mar 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Authorized official

Name
Haris Inam Mirza, M.D.NPI 1912956335
Title
President
Phone
(352) 401-7552

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
Infectious Disease Physician 207RI0200X ME88195 FL Primary

Addresses

Primary practice location

321 SE 29TH PL
Suite 101
Ocala, FL 34471-0489

Mailing address

PO Box 5580
Ocala, FL 34478-5580
Phone (352) 401-7552

Other identifiers 2

IdentifierTypeStateIssuer
267672900MedicaidFL
K8951OtherMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051118000331 FL Part B Supplier - Clinic/Group Practice 9234158296 Receives reassigned benefits from 16 practitioners
Practice locations: Ocala, FL

National Provider Directory

National Provider Directory

Locations

2651 SW 32nd Pl
Ocala, FL 34471
Phone (352) 401-7552

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19367/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1093911935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5580",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344785580",
            "telephone_number": "352-401-7552",
            "fax_number": "352-622-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 SE 29TH PL",
            "address_2": "SUITE 101",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344710489",
            "telephone_number": "352-401-7552",
            "fax_number": "352-622-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCALA INFECTIOUS DISEASE AND WOUND CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "HARIS",
        "authorized_official_middle_name": "INAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-401-7552",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME88195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267672900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K8951",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.