Individual provider Active NPI

Nick Ashok Mahavir, DPM

  • Podiatrist
  • Ocoee, FL
National Provider Identifier
1245225416
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO0003217 Issued in FL
Practice address
1140 Kelton Ave
BLDG 3
Ocoee, FL 34761-3175
Phone
(407) 521-7999
Fax
(407) 521-2227
NPI assigned
Sep 14, 2005
Last updated
Apr 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO0003217 FL Primary

Addresses

Primary practice location

1140 Kelton Ave
BLDG 3
Ocoee, FL 34761-3175

Mailing address

1140 Kelton Ave
Building 3
Ocoee, FL 34761-3175
Phone (407) 521-7999

Other identifiers 2

IdentifierTypeStateIssuer
340533800MedicaidFL
65906OtherFLBCBS

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051228000515 FL Practitioner - Podiatry 7012939457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1140 Kelton Ave
Ocoee, FL 34761-3175
Phone (407) 521-7999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue152
Removal of skin lesions1-10
Removal of nail tissue41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO0003217FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Foot & Ankle of Central Florida CurrentSince Aug 1, 2008 Accepting new patients

Locations

1140 Kelton Ave
Ocoee, FL 34761
Phone (407) 521-7999

1140 Kelton Ave
#3
Ocoee, FL 34761

1140 Kelton Ave
Bldg 3
Ocoee, FL 34761
Phone (407) 521-7999

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1245225416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 KELTON AVE",
            "address_2": "BUILDING 3",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613175",
            "telephone_number": "407-521-7999",
            "fax_number": "407-521-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 KELTON AVE",
            "address_2": "BLDG 3",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613175",
            "telephone_number": "407-521-7999",
            "fax_number": "407-521-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAVIR",
        "first_name": "NICK",
        "middle_name": "ASHOK",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO0003217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340533800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "65906",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.