Individual provider Active NPI

Mamdouh Hassan Zeini, M.D., PH.D

  • Ophthalmology Physician
  • Lady Lake, FL
National Provider Identifier
1184794372
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0071525 Issued in FL
Practice address
936 Bichara Blvd
Lady Lake, FL 32159-7714
Phone
(352) 753-9888
Fax
(352) 753-0947
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME0071525 FL Primary

Addresses

Primary practice location

936 Bichara Blvd
Lady Lake, FL 32159-7714

Mailing address

936 Bichara Blvd
Lady Lake, FL 32159-7714
Phone (352) 753-9888

Other identifiers 1

IdentifierTypeStateIssuer
251540700MedicaidFL

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
I20100819000305 FL Practitioner - Ophthalmology 0143288837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3479 Wedgewood LN
The Villages, FL 32162-7183
Phone (352) 751-0600

936 Bichara Blvd
Lady Lake, FL 32159-7714
Phone (352) 753-9888

Merit-based Incentive Payment System (MIPS)

Final score
98.35 of 100Reported as individual
Quality
96.7
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0071525FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Surgical and Medical Eye Care P a Ophthalmology CurrentSince Oct 28, 1999 Accepting new patients
Advanced Surgical and Medical Eye Care P a Ophthalmology CurrentSince Jul 16, 1998 Accepting new patients
Advanced Surgical and Medical Eye Care Ophthalmology Past Accepting new patients
Ocala FL ASC LLC PastSince Jun 30, 2005 Accepting new patients

Locations

936 Bichara Blvd
Lady Lake, FL 32159
Phone (352) 753-9888

2381 SW College Rd
Ocala, FL 34471
Phone (352) 351-2020

3479 Wedgewood Ln
The Villages, FL 32162
Phone (352) 751-0060

Interoperability endpoints

  • Direct secure messaging: direct@advancedsurgmedeyecarepaladylakefl.compulinkdirect.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1184794372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 BICHARA BLVD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321597714",
            "telephone_number": "352-753-9888",
            "fax_number": "352-753-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 BICHARA BLVD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321597714",
            "telephone_number": "352-753-9888",
            "fax_number": "352-753-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEINI",
        "first_name": "MAMDOUH",
        "middle_name": "HASSAN",
        "credential": "M.D., PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0071525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251540700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.