Individual provider Active NPI

Noushad Mamun, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Orlando, FL
National Provider Identifier
1134757362
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
OS22946 Issued in FL
Practice address
13564 Village Park Dr Unit 150
Orlando, FL 32837-7765
Phone
(321) 843-5851
Fax
(407) 599-1691
NPI assigned
Apr 1, 2020
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X OS22946 FL Primary

Addresses

Primary practice location

13564 Village Park Dr Unit 150
Orlando, FL 32837-7765

Mailing address

13564 Village Park Dr Unit 150
Orlando, FL 32837-7765
Phone (321) 843-5851

Other practice location 1

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 987-2000

Other practice location 2

16966 Cagan Ridge Blvd Ste 220
Clermont, FL 34714-9656
Phone (321) 843-5851

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
I20251106000026 FL Practitioner - Pain Management 2365863958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
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
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

13564 Village Park Dr
Unit 150
Orlando, FL 32837-7765
Phone (321) 843-5851

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS22946FLMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Nov 1, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Nov 1, 2025 Accepting new patients

Locations

16966 Cagan Ridge Blvd
Ste 220
Clermont, FL 34714
Phone (407) 347-2979

1920 Don Wickham Dr
Clermont, FL 34711
Phone (352) 243-5891

13564 Village Park Dr
Unit 150
Orlando, FL 32837

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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 3

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1134757362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13564 VILLAGE PARK DR UNIT 150",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377765",
            "telephone_number": "321-843-5851",
            "fax_number": "407-599-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13564 VILLAGE PARK DR UNIT 150",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377765",
            "telephone_number": "321-843-5851",
            "fax_number": "407-599-1691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Johnson St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215421",
            "country_code": "US",
            "telephone_number": "954-987-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16966 Cagan Ridge Blvd Ste 220",
            "address_purpose": "LOCATION",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347149656",
            "country_code": "US",
            "telephone_number": "321-843-5851",
            "fax_number": "352-386-9748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMUN",
        "first_name": "NOUSHAD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "OS22946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.