Individual provider Active NPI

Aimee Pooneh Vafaie, MD

  • Pediatrics Physician
  • Fort Walton Beach, FL
National Provider Identifier
1215958756
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME129495 Issued in FL
Practice address
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone
(214) 676-1531
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L9529 TX
Pediatrics Physician 208000000X ME129495 FL Primary

Addresses

Primary practice location

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Mailing address

1317 Edgewater Dr Unit 495
Orlando, FL 32804-6350
Phone (214) 676-1531

Other identifiers 1

IdentifierTypeStateIssuer
166331203MedicaidTX

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
I20161119000239 FL Practitioner - Pediatric Medicine 3375517683 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME129495FLMDPediatrics Physician
L9529TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Hospital Physician Services of Florida PA CurrentSince Jun 1, 2017 Accepting new patients
Paragon Emergency Services LLC Pediatrics CurrentSince Jun 14, 2017 Accepting new patients
Emergency Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Blue Job Emergency Physicians LLC Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

Organizations & group practices 5

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1215958756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 EDGEWATER DR UNIT 495",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046350",
            "telephone_number": "214-676-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "214-676-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAFAIE",
        "first_name": "AIMEE",
        "middle_name": "POONEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L9529",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME129495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166331203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.