NPIMap

Individual provider Active NPI

Mahmoud Altawil, MD

  • Cardiovascular Disease Physician
  • Orlando, FL
National Provider Identifier
1104264308
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME150633 Issued in FL
Practice address
258 S Chickasaw TRL Ste 203
Orlando, FL 32825-3558
Phone
(407) 303-6588
Fax
(407) 303-6592
NPI assigned
Jun 10, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME150633 FL Primary

Addresses

Primary practice location

258 S Chickasaw TRL Ste 203
Orlando, FL 32825-3558

Mailing address

258 S Chickasaw TRL Ste 203
Orlando, FL 32825-3558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210811004398 FL Practitioner - Cardiovascular Disease (Cardiology) 4880994649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Miami, LM Miller School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

9975 Tavistock Lakes Blvd
Suite 220
Orlando, FL 32827-7665
Phone (407) 930-7801

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME150633FLMDCardiovascular Disease Physician

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Aug 16, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 16, 2021 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

3701 Avalon Park West Blvd
Ste 205
Orlando, FL 32828
Phone (407) 303-6285

258 S Chickasaw Trl
Ste 203
Orlando, FL 32825
Phone (407) 303-6588

9975 Tavistock Lakes Blvd
Ste 220
Orlando, FL 32827
Phone (407) 930-7800

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: maltawil73778@adventhealth.direct-ci.com
  • Direct secure messaging: maltawil415262@direct.hfhs.org

Organizations & group practices 12

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 2

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": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1104264308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253558",
            "telephone_number": "407-303-6588",
            "fax_number": "407-303-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTAWIL",
        "first_name": "MAHMOUD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME150633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.