Individual provider Active NPI

Muhammed Y Memon, M.D.

  • Neurological Surgery Physician
  • Port Charlotte, FL
National Provider Identifier
1326031931
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME0022458 Issued in FL
Practice address
2852 Tamiami TRL Ste 5
Port Charlotte, FL 33952
Phone
(941) 625-9494
Fax
(941) 743-8562
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME0022458 FL Primary

Addresses

Primary practice location

2852 Tamiami TRL Ste 5
Port Charlotte, FL 33952

Mailing address

2852 Tamiami TRL Ste 5
Port Charlotte, FL 33952-5100
Phone (941) 625-9494

Other practice location 1

2400 Harbor Blvd
10
Port Charlotte, FL 33952-5052
Phone (941) 625-0414

Other identifiers 1

IdentifierTypeStateIssuer
08109OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

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
ME0022458FLMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Resources Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1326031931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 TAMIAMI TRL STE 5",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525100",
            "telephone_number": "941-625-9494",
            "fax_number": "941-743-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 TAMIAMI TRL STE 5",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33952",
            "telephone_number": "941-625-9494",
            "fax_number": "941-743-8562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Harbor Blvd",
            "address_2": "10",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339525052",
            "country_code": "US",
            "telephone_number": "941-625-0414",
            "fax_number": "941-625-5984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEMON",
        "first_name": "MUHAMMED",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME0022458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08109",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.