Individual provider Active NPI

Max Kenny Fon Sing, MD

  • Internal Medicine Physician
  • Brandon, FL
National Provider Identifier
1154436228
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME102048 Issued in FL
Practice address
1291 Bloomingdale Ave
Brandon, FL 33596-6168
Phone
(813) 653-1800
Fax
(813) 651-0932
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 ME102048 FL Primary

Addresses

Primary practice location

1291 Bloomingdale Ave
Brandon, FL 33596-6168

Mailing address

1291 Bloomingdale Ave
Valrico, FL 33596-6168
Phone (813) 653-1880

Other identifiers 1

IdentifierTypeStateIssuer
000984200MedicaidFL

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
I20090211000579 FL Practitioner - Internal Medicine 2769499193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

1291 Bloomingdale Ave
Valrico, FL 33596-6168
Phone (813) 653-1880

1345 W Bay Dr
202 Optum Largo
Largo, FL 33770-2276
Phone (727) 559-0895

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME102048FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida, LLC CurrentSince Sep 1, 2011 Accepting new patients
Optumcare Florida LLC Internal Medicine CurrentSince Sep 1, 2011 Accepting new patients
Ernesto Zavaleta, MD, PA Internal Medicine Past Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

406 W Bloomingdale Ave
Brandon, FL 33511
Phone (813) 653-1880

1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

1291 Bloomingdale Ave
Valrico, FL 33596
Phone (813) 653-1880

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1154436228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1291 BLOOMINGDALE AVE",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966168",
            "telephone_number": "813-653-1880",
            "fax_number": "813-654-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1291 BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335966168",
            "telephone_number": "813-653-1800",
            "fax_number": "813-651-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FON SING",
        "first_name": "MAX",
        "middle_name": "KENNY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-03-07",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME102048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000984200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.