Individual provider Active NPI

Mohammad Tariq Agha, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Winter Park, FL
National Provider Identifier
1265660856
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2014013909 Issued in MO
Practice address
200 N Lakemont Ave
Winter Park, FL 32792-3273
Phone
(407) 646-7000
NPI assigned
Jun 23, 2009
Last updated
Jul 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116022337 VA
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X 2014013909 MO Primary

Addresses

Primary practice location

200 N Lakemont Ave
Winter Park, FL 32792-3273

Mailing address

200 N Lakemont Ave
Winter Park, FL 32792-3273

Other practice location 1

Department Of Pm&r
1 Hospital Drive, DC046.00
Columbia, MO 65212-0001
Phone (573) 882-3101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141008000052 MO Practitioner - Physical Medicine and Rehabilitation 6901044874 Reassigns benefits to 1 organization
I20251103003854 FL Practitioner - Physical Medicine and Rehabilitation 6901044874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Missouri, Kansas City, School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014013909MOMDPhysical Medicine & Rehabilitation Physician
0116022337VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Post-Acute Physicians of Missouri PC Physical Medicine & Rehabilitation CurrentSince Dec 16, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 3, 2025 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 3, 2025 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

200 N Lakemont Ave
Winter Park, FL 32792
Phone (407) 646-7000

12380 De Paul Dr
Bridgeton, MO 63044
Phone (314) 447-9700

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

2800 Hospital Dr
North Kansas City, MO 64116
Phone (816) 221-5050

1776 Woodstead Ct
Ste 208
The Woodlands, TX 77380
Phone (281) 724-3100

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: magha5237888@adventhealth.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1265660856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N LAKEMONT AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N LAKEMONT AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923273",
            "telephone_number": "407-646-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Department Of Pm&r",
            "address_2": "1 Hospital Drive, DC046.00",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652120001",
            "country_code": "US",
            "telephone_number": "573-882-3101",
            "fax_number": "573-884-4540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGHA",
        "first_name": "MOHAMMAD",
        "middle_name": "TARIQ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116022337",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2014013909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.