NPIMap

Individual provider Active NPI

Mairaj Uddin, M.D.

  • Internal Medicine Physician
  • Seminole, FL
National Provider Identifier
1144329285
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME95461 Issued in FL
Practice address
9677 Seminole Blvd
Seminole, FL 33772
Phone
(727) 490-9096
Fax
(727) 490-9299
NPI assigned
Sep 22, 2006
Last updated
Jun 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME95461 FL Primary

Addresses

Primary practice location

9677 Seminole Blvd
Seminole, FL 33772

Mailing address

9677 Seminole Blvd
Seminole, FL 33772-2526
Phone (727) 904-9096

Other practice location 1

646 Virginia St Ste 201
Dunedin, FL 34698-6612
Phone (727) 490-9096

Other identifiers 1

IdentifierTypeStateIssuer
P01115731OtherFLRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070428000022 FL Practitioner - Internal Medicine 2961508510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
All American Family and Geriatric Care PLLCGroup PAC ID 3577711779, 3 clinicians

Practice addresses (Care Compare)

9677 Seminole Blvd
Seminole, FL 33772-2526
Phone (727) 490-9096

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME95461FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
All American Family and Geriatric Care PLLC CurrentSince Nov 27, 2013 Accepting new patients
Innovative Health Services, LLC Internal Medicine Current Accepting new patients

Locations

646 Virginia St
Ste 201
Dunedin, FL 34698
Phone (727) 306-0231

9677 Seminole Blvd
Seminole, FL 33772
Phone (727) 319-2952

Networks

  • Freedom Health HMO Network

Interoperability endpoints

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

Organizations & group practices 3

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 5

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1144329285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9677 SEMINOLE BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337722526",
            "telephone_number": "727-904-9096",
            "fax_number": "727-490-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9677 SEMINOLE BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "33772",
            "telephone_number": "727-490-9096",
            "fax_number": "727-490-9299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "646 Virginia St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Dunedin",
            "state": "FL",
            "postal_code": "346986612",
            "country_code": "US",
            "telephone_number": "727-490-9096",
            "fax_number": "727-490-9299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDDIN",
        "first_name": "MAIRAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME95461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01115731",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

Verify at the official NPI Registry.