Mohammad Tariq Agha, M.D.
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Winter Park, FL
NPI 1265660856 · NPPES record last updated Jul 10, 2025
Key facts
- NPI
- 1265660856
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 2014013909 (MO)
- Practice address
- 200 N Lakemont Ave
Winter Park, FL 32792-3273 - Phone
- (407) 646-7000
- NPI assigned
- Jun 23, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Medicare Care Compare profile
- 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 Inc
Practice addresses (Care Compare)
2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0116022337 | VA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles (3 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Post-Acute Physicians of Missouri PC | Physical Medicine & Rehabilitation | Current |
Accepting new patients |
| Florida Hospital Medical Group Inc | Current |
Accepting new patients | |
| Florida Hospital Medical Group Inc | Current |
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
- magha5237888@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 | Yes |
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
Other providers in Winter Park, FL
- Affluent Learning Center PLLC
- Afm Healthcare
- Agape Medical Transporation LLC
- Age Rejuvenation Medical, P.a.
- Monica Aggarwal
- Eric Agnew
- Philip Agostinelli
- Margarita Aguayo
- Andrea Agudelo
- Cynthia Aguilar
All providers in Winter Park, FL · Physical Medicine & Rehabilitation Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.