NPIMap

Organization Active NPI

Manoogian Orthopedic Center, P.a.

  • Orthopaedic Surgery Physician
  • Mount Dora, FL
National Provider Identifier
1205945763
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
MANOOGIAN ORTHOPEDIC CENTER, P.A.
Practice address
1945 Bay Rd
Mount Dora, FL 32757
Phone
(352) 483-5633
Fax
(352) 483-5070
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Dr. Vrej K Manoogian, D.O.NPI 1275529455
Title
President
Phone
(352) 483-5633

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
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1945 Bay Rd
Mount Dora, FL 32757

Mailing address

1945 Bay Rd
Mount Dora, FL 32757-2105
Phone (352) 483-5633

Other identifiers 6

IdentifierTypeStateIssuer
P00260225OtherFLRAILROAD MEDICARE GURU
DD9204OtherFLRAILROAD MEDICARE GROUP
16714OtherFLBCBSFL SAMIR GURU, D.O.
200041567OtherFLRAILROAD MEDICARE MANOOGI
46883OtherFLBCBSFL VREJ MANOOGIAN, D.
94957OtherFLBCBSFL GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041019000492 FL Part B Supplier - Clinic/Group Practice 6507826096 Receives reassigned benefits from 9 practitioners
Practice locations: Mount Dora, FL; The Villages, FL; Tavares, FL; Summerfield, FL; Leesburg, FL

National Provider Directory

National Provider Directory

Locations

1945 Bay Rd
Mount Dora, FL 32757
Phone (352) 483-5633

3900 Lake Center Dr
Mount Dora, FL 32757

3900 Lake Center Dr
Ste 1
Mount Dora, FL 32757
Phone (352) 483-5633

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1205945763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 BAY RD",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572105",
            "telephone_number": "352-483-5633",
            "fax_number": "352-483-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 BAY RD",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "32757",
            "telephone_number": "352-483-5633",
            "fax_number": "352-483-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOOGIAN ORTHOPEDIC CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "MANOOGIAN",
        "authorized_official_first_name": "VREJ",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-483-5633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GURU",
            "identifier": "P00260225",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DD9204",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL SAMIR GURU, D.O.",
            "identifier": "16714",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE MANOOGI",
            "identifier": "200041567",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL VREJ MANOOGIAN, D.",
            "identifier": "46883",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL GROUP",
            "identifier": "94957",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.