Individual provider Active NPI

Asif F Kamal, MD

  • Internal Medicine Physician
  • Port Charlotte, FL
National Provider Identifier
1235122953
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0071572 Issued in FL
Practice address
21202 Olean Blvd Ste C6
Port Charlotte, FL 33952-6771
Phone
(941) 889-7440
Fax
(941) 391-6089
NPI assigned
Aug 28, 2005
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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 ME0071572 FL Primary

Addresses

Primary practice location

21202 Olean Blvd Ste C6
Port Charlotte, FL 33952-6771

Mailing address

21202 Olean Blvd Ste C6
Port Charlotte, FL 33952-6771
Phone (941) 889-7440

Other identifiers 3

IdentifierTypeStateIssuer
251051100MedicaidFL
32468OtherFLBCBS
0007380241OtherFLAETNA

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
I20041229000124 FL Practitioner - Internal Medicine 6800854449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2500 Harbor Blvd
Port Charlotte, FL 33952-5000
Phone (941) 766-4122

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0071572FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asif Kamal MD PA Internal Medicine CurrentSince May 1, 2014 Accepting new patients
Tanweer Memon MD PA Internal Medicine Past Accepting new patients

Locations

21202 Olean Blvd
Ste C1
Port Charlotte, FL 33952
Phone (941) 889-7440

21202 Olean Blvd
Ste C6
Pt Charlotte, FL 33952
Phone (941) 889-7440

2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122

3005 Caring Way
Ste 1
Pt Charlotte, FL 33952
Phone (941) 249-8493

3005 Caring Way
Ste 2
Pt Charlotte, FL 33952
Phone (304) 615-6029

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIABBA

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1235122953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21202 OLEAN BLVD STE C6",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526771",
            "telephone_number": "941-889-7440",
            "fax_number": "941-391-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21202 OLEAN BLVD STE C6",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526771",
            "telephone_number": "941-889-7440",
            "fax_number": "941-391-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMAL",
        "first_name": "ASIF",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-28",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0071572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251051100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "32468",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007380241",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.