Individual provider Active NPI

Mitchell Lewis Supler, MD

  • Neurological Surgery Physician
  • Ocoee, FL
National Provider Identifier
1114990553
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME 64445 Issued in FL
Practice address
10000 W Colonial Dr Ste 284
Ocoee, FL 34761-3432
Phone
(321) 841-1570
Fax
(321) 841-8185
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME 64445 FL Primary

Addresses

Primary practice location

10000 W Colonial Dr Ste 284
Ocoee, FL 34761-3432

Mailing address

10000 W Colonial Dr Ste 284
Ocoee, FL 34761-3432
Phone (321) 841-1570

Other practice location 1

2706 Rew Cir
Ocoee, FL 34761-4215
Phone (407) 649-8585

Other identifiers 2

IdentifierTypeStateIssuer
119418200MedicaidFL
46892OtherFLBCBS

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
I20080211000046 FL Practitioner - Neurosurgery 8921181223 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Florida College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

10000 W Colonial Dr
Suite 284
Ocoee, FL 34761-3432
Phone (321) 841-1570

1200 Lexington Green LN
Sanford, FL 32771-1013

Hospital & facility affiliations

  • Kassy Home Health Home health agency, Maitland, FL, CCN 683132
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health Hospital, Orlando, FL, CCN 100006

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion14
Laminectomy or laminotomy (partial removal of spine bones)26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 64445FLMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Consultants of FL, PA Neurological Surgery CurrentSince May 25, 2016 Accepting new patients
Orlando Health Medical Group Inc Neurological Surgery CurrentSince Aug 25, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 25, 2023 Accepting new patients
Osler Medical Inc Past Accepting new patients
Sebastian Hma Physician Management LLC Past Accepting new patients

Locations

240 N Wickham Rd
Ste 300
Melbourne, FL 32935
Phone (321) 308-5050

2706 Rew Cir
Ste 100
Ocoee, FL 34761
Phone (407) 649-8585

10000 W Colonial Dr
Ste 284
Ocoee, FL 34761
Phone (321) 841-1570

2706 Rew Cir
Ste 200
Ocoee, FL 34761
Phone (407) 614-8337

2706 Rew Cir
Ocoee, FL 34761
Phone (321) 842-4800

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

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 7

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1114990553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 284",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613432",
            "telephone_number": "321-841-1570",
            "fax_number": "321-841-8185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 284",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613432",
            "telephone_number": "321-841-1570",
            "fax_number": "321-841-8185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2706 Rew Cir",
            "address_purpose": "LOCATION",
            "city": "Ocoee",
            "state": "FL",
            "postal_code": "347614215",
            "country_code": "US",
            "telephone_number": "407-649-8585",
            "fax_number": "407-649-0151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUPLER",
        "first_name": "MITCHELL",
        "middle_name": "LEWIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME 64445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119418200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46892",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.