Individual provider Active NPI

Michael J. Sforzini, MD

  • Internal Medicine Physician
  • Lady Lake, FL
National Provider Identifier
1124066402
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
138984 Issued in FL
Practice address
753 Co Rd 466
Lady Lake, FL 32159
Phone
(352) 268-0003
Fax
(855) 642-0650
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16569 AL
Hospitalist Physician 208M00000X MD.16569 AL
Internal Medicine Physician 207R00000X 138984 FL Primary

Addresses

Primary practice location

753 Co Rd 466
Lady Lake, FL 32159

Mailing address

753 Co Rd 466
Lady Lake, FL 32159
Phone (352) 268-0003

Other identifiers 4

IdentifierTypeStateIssuer
009924830MedicaidAL
51094565OtherALBCBS
04-11590OtherALUNITED HEALTHCARE
51094568OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20100614000763 AL Practitioner - Internal Medicine 8224168463 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16569ALMDInternal Medicine Physician
138984FLMDInternal Medicine Physician
MD.16569ALMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Primary Health Center, Inc Internal Medicine CurrentSince May 1, 2012 Accepting new patients
Franklin Primary Health Center Inc. Internal Medicine CurrentSince May 1, 2012 Accepting new patients
Inpatient Consultants of Alabama, Inc Internal Medicine CurrentSince Sep 20, 2013 Accepting new patients
Tricounty Health LLC Internal Medicine CurrentSince Mar 6, 2019 Accepting new patients

Locations

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

1303 Dr Martin L King Jr Ave
#A
Mobile, AL 36603

735 S Washington Ave
Mobile, AL 36603
Phone (251) 433-2642

3719 Dauphin St
Mobile, AL 36608
Phone (251) 342-3000

1303 Dr Martin L King Jr Ave
Mobile, AL 36603
Phone (251) 436-7646

1720 Knowles Rd
Phenix City, AL 36869
Phone (334) 291-0485

753 Highway 466
Lady Lake, FL 32159
Phone (321) 248-2666

4056 E State Road 44
Wildwood, FL 34785
Phone (321) 248-2666

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJGBD

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1124066402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 CO RD 466",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-268-0003",
            "fax_number": "855-642-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 CO RD 466",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-268-0003",
            "fax_number": "855-642-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SFORZINI",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "16569",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AL",
            "license": "MD.16569",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "138984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009924830",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51094565",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "04-11590",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51094568",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.