Individual provider Active NPI

Syed Salman M Moinuddin, M.D.

  • Internal Medicine Physician
  • Mount Dora, FL
National Provider Identifier
1285894238
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 109311 Issued in FL
Practice address
18550 US Highway 441
Suite a
Mount Dora, FL 32757-6751
Phone
(352) 735-3755
Fax
(352) 735-3151
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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 ME 109311 FL Primary

Addresses

Primary practice location

18550 US Highway 441
Suite a
Mount Dora, FL 32757-6751

Mailing address

18550 US Highway 441
Suite a
Mount Dora, FL 32757-6751
Phone (352) 735-3755

Other identifiers 1

IdentifierTypeStateIssuer
109311OtherFLME 109311

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
I20111215000322 FL Practitioner - Internal Medicine 1052586351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians of Central Florida, LLCGroup PAC ID 5395712764, 10 clinicians

Practice addresses (Care Compare)

18550 US Hwy 441
Mount Dora, FL 32757-6751
Phone (352) 735-3755

Hospital & facility affiliations

  • Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290
  • Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 109311FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of Central Florida PA Internal Medicine CurrentSince Nov 1, 2011 Accepting new patients
Physicians of Central Florida, LLC Internal Medicine CurrentSince Nov 1, 2011 Accepting new patients

Locations

18550 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-3755

18550 US Highway 441
Ste A
Mount Dora, FL 32757
Phone (352) 735-3755

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

Interoperability endpoints

  • Direct secure messaging: smoinuddin562686@direct.shands.ufl.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1285894238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18550 US HIGHWAY 441",
            "address_2": "SUITE A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576751",
            "telephone_number": "352-735-3755",
            "fax_number": "352-735-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18550 US HIGHWAY 441",
            "address_2": "SUITE A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576751",
            "telephone_number": "352-735-3755",
            "fax_number": "352-735-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOINUDDIN",
        "first_name": "SYED SALMAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 109311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ME 109311",
            "identifier": "109311",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.