Organization Active NPI

Timothy P Mason DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Oviedo, FL
National Provider Identifier
1205079571
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3355 Issued in FL
Legal business name
TIMOTHY P MASON DPM PA
Practice address
2645 W State Road 426 Ste 1101
Oviedo, FL 32765-8371
Phone
(407) 365-9511
Fax
(407) 365-9311
NPI assigned
Apr 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Authorized official

Name
Dr. Timothy P Mason, D. P. M.NPI 1366642373
Title
Administrator
Phone
(407) 365-9511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO3355 FL Primary

Addresses

Primary practice location

2645 W State Road 426 Ste 1101
Oviedo, FL 32765-8371

Mailing address

2645 W State Road 426 Ste 1101
Oviedo, FL 32765-8371
Phone (407) 365-9511

Other identifiers 1

IdentifierTypeStateIssuer
001354900MedicaidFL

Other names 1

  • Foot and Ankle Specialists of Orlando Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090605000349 FL Part B Supplier - Clinic/Group Practice 2163572587 Receives reassigned benefits from 4 practitioners
Practice locations: Lake Mary, FL; Oviedo, FL
O20100930044047 FL DME Supplier - Physician - Podiatry 2163572587 Practice locations: Oviedo, FL

National Provider Directory

National Provider Directory

Locations

2645 W State Road 426
Ste 101
Oviedo, FL 32765
Phone (407) 365-9511

1000 W Broadway St
Ste 103
Oviedo, FL 32765
Phone (407) 365-9511

2645 W State Road 426
#1101
Oviedo, FL 32765
Phone (407) 365-9511

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1205079571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 W STATE ROAD 426 STE 1101",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658371",
            "telephone_number": "407-365-9511",
            "fax_number": "407-365-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 W STATE ROAD 426 STE 1101",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658371",
            "telephone_number": "407-365-9511",
            "fax_number": "407-365-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY P MASON DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-365-9511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. P. M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001354900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot and Ankle Specialists of Orlando",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.