Individual provider Active NPI

Samir Rahman

  • Surgery Physician
  • Inverness, FL
National Provider Identifier
1275020463
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
PENDING Issued in FL
Practice address
104 S Pine Ave
Inverness, FL 34452
Phone
(352) 726-3646
Fax
(352) 726-0079
NPI assigned
Apr 13, 2018
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X PENDING FL Primary

Addresses

Primary practice location

104 S Pine Ave
Inverness, FL 34452

Mailing address

502 W Highland Blvd
Inverness, FL 34452-4720
Phone (364) 635-2706

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
I20231025001570 FL Practitioner - General Surgery 5799131843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Touro Un Col of Osteopathic Medicine, New York, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citrus Specialty Group IncGroup PAC ID 8022331255, 14 clinicians

Practice addresses (Care Compare)

104 S Pine Ave
Inverness, FL 34452-4829
Phone (352) 726-3646

502 W Highland Blvd
Inverness, FL 34452-4720
Phone (352) 726-1551

800 Medical CT E
Inverness, FL 34452-4612
Phone (352) 726-7667

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.07 of 100Reported as individual
Quality
82.8
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)12
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGFLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Specialty Group, Inc Surgery CurrentSince Oct 16, 2023 Accepting new patients

Locations

104 S Pine Ave
Inverness, FL 34452
Phone (352) 726-3646

403 W Highland Blvd
Inverness, FL 34452
Phone (352) 726-3646

502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481

800 Medical Ct E
Inverness, FL 34452
Phone (352) 726-7667

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: samir.rahman@hca4.eclinicaldirectplus.com

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1275020463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W HIGHLAND BLVD",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524720",
            "telephone_number": "364-635-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S PINE AVE",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "34452",
            "telephone_number": "352-726-3646",
            "fax_number": "352-726-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "SAMIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-13",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

Verify at the official NPI Registry.