Individual provider Active NPI

Loc Kim Le, M.D.

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1316164205
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME93883 Issued in FL
Practice address
1317 N Pine Hills Rd
Orlando, FL 32808-4833
Phone
(407) 532-4615
NPI assigned
Apr 20, 2007
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME93883 FL Primary

Addresses

Primary practice location

1317 N Pine Hills Rd
Orlando, FL 32808-4833

Mailing address

1317 N Pine Hills Rd
Orlando, FL 32808-4833
Phone (407) 532-4615

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
I20070802000648 FL Practitioner - Family PracticePractitioner - General Practice 1153412226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1317 N Pine Hills Rd
Orlando, FL 32808-4833
Phone (407) 532-4615

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME93883FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Family Care PA CurrentSince May 14, 2007 Accepting new patients
Lake Family Practice PastSince May 14, 2007 Accepting new patients

Locations

1317 N Pine Hills Rd
Orlando, FL 32808
Phone (407) 532-4615

5026 Silver Star Rd
Orlando, FL 32808
Phone (407) 291-1305

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, 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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1316164205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 N PINE HILLS RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328084833",
            "telephone_number": "407-532-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 N PINE HILLS RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328084833",
            "telephone_number": "407-532-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "LOC",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME93883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.