Individual provider Active NPI

Ravindra S. Tak, M.D.

  • Family Medicine Physician
  • Ocoee, FL
National Provider Identifier
1124017827
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME63815 Issued in FL
Practice address
1134 Kelton Ave
Suite a
Ocoee, FL 34761-3100
Phone
(407) 306-6306
Fax
(407) 306-6304
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME63815 FL Primary

Addresses

Primary practice location

1134 Kelton Ave
Suite a
Ocoee, FL 34761-3100

Mailing address

1134 Kelton Ave Ste a
Ocoee, FL 34761-3100
Phone (407) 306-6306

Other identifiers 1

IdentifierTypeStateIssuer
002339700MedicaidFL

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
I20100330001246 FL Practitioner - General Practice 6507992427 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

21 Columbia St
Orlando, FL 32806-1133
Phone (321) 841-6600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Physicians Network Inc Family Medicine CurrentSince May 29, 2020 Accepting new patients
Central Florida Inpatient Medicine LLC CurrentSince Jan 9, 2018 Accepting new patients
Orlando Health Medical Group Inc Past Accepting new patients

Locations

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

1134 Kelton Ave
Ste A
Ocoee, FL 34761
Phone (407) 306-6306

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

Interoperability endpoints

  • Direct secure messaging: rtak25606@orlandohealth.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1124017827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 KELTON AVE STE A",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613100",
            "telephone_number": "407-306-6306",
            "fax_number": "407-306-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 KELTON AVE",
            "address_2": "SUITE A",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613100",
            "telephone_number": "407-306-6306",
            "fax_number": "407-306-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAK",
        "first_name": "RAVINDRA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME63815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002339700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.