Individual provider Active NPI

Mohammad Ilyas, M.D.

  • Pediatric Nephrology Physician
  • Orlando, FL
National Provider Identifier
1104895416
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
ME75454 Issued in FL
Practice address
615 E Princeton St Ste 401
Orlando, FL 32803-1469
Phone
(407) 303-9311
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X ME75454 FL Primary
Pediatrics Physician 208000000X ME75454 FL

Addresses

Primary practice location

615 E Princeton St Ste 401
Orlando, FL 32803-1469

Mailing address

615 E Princeton St Ste 401
Orlando, FL 32803-1469
Phone (407) 303-9311

Other practice location 1

820 Prudential Dr Ste 405
UFJP Pediatric Multispecialty
Jacksonville, FL 32207-8206
Phone (904) 633-0920

Other identifiers 3

IdentifierTypeStateIssuer
000923898AMedicaidGA
2593840-00MedicaidFL
370020436OtherFLRAILROAD MEDICARE

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
I20051019000737 FL Practitioner - NephrologyPractitioner - Pediatric Medicine 9133145154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1990
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)

615 E Princeton St
Suite 401
Orlando, FL 32803-1469
Phone (407) 303-9926

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Nov 9, 2001 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Pediatrics CurrentSince Nov 9, 2001 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

101 W 12th St
Jacksonville, FL 32206
Phone (904) 358-0888

820 Prudential Dr
Ste 405
Jacksonville, FL 32207
Phone (904) 633-0920

841 Prudential Dr
Ste 100
Jacksonville, FL 32207
Phone (904) 633-4110

841 Prudential Dr
Ste 1900
Jacksonville, FL 32207
Phone (904) 427-8453

Interoperability endpoints

  • Direct secure messaging: milyas59369@direct.shands.ufl.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1104895416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 401",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031469",
            "telephone_number": "407-303-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 401",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031469",
            "telephone_number": "407-303-9311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Prudential Dr Ste 405",
            "address_2": "UFJP Pediatric Multispecialty",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078206",
            "country_code": "US",
            "telephone_number": "904-633-0920",
            "fax_number": "904-600-0921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILYAS",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "FL",
            "license": "ME75454",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME75454",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000923898A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2593840-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "370020436",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.