Individual provider Active NPI

Mohammadreza Minouei, MD

  • Hospitalist Physician
  • Daytona Beach, FL
National Provider Identifier
1316074701
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME103732 Issued in FL
Practice address
303 N. Clyde Morris Blvd
Suite 201
Daytona Beach, FL 32114-2709
Phone
(386) 226-4542
Fax
(386) 229-2354
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD430780 PA
Hospitalist Physician 208M00000X ME103732 FL Primary

Addresses

Primary practice location

303 N. Clyde Morris Blvd
Suite 201
Daytona Beach, FL 32114-2709

Mailing address

303 N. Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone (386) 425-2285

Other identifiers 1

IdentifierTypeStateIssuer
101855627MedicaidPA

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
I20100817001703 FL Practitioner - HospitalistPractitioner - Critical Care (Intensivists) 6901909506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Critical Care (Intensivists)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

303 N Clyde Morris Blvd
Daytona BCH, FL 32114-2709
Phone (386) 254-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD430780PAMDInternal Medicine Physician
ME103732FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Feb 15, 2015 Accepting new patients
Halifax Healthcare Systems Inc Hospitalist CurrentSince Jun 1, 2011 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Feb 15, 2015 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine Current Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

303 N Clyde Morris Blvd
Ste 201
Daytona Beach, FL 32114
Phone (386) 226-4542

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

1431 SW 1st Ave
Ocala, FL 34471
Phone (352) 401-1425

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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 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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1316074701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N. CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-2285",
            "fax_number": "386-425-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N. CLYDE MORRIS BLVD",
            "address_2": "SUITE 201",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-226-4542",
            "fax_number": "386-229-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOUEI",
        "first_name": "MOHAMMADREZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD430780",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME103732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101855627",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.