NPIMap

Individual provider Active NPI

Mohammed Amzad Hossain, M.D.

  • Nephrology Physician
  • Lady Lake, FL
National Provider Identifier
1346620770
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME126913 Issued in FL
Practice address
929 N US Highway 441 Ste 503
Lady Lake, FL 32159
Phone
(352) 578-2486
Fax
(352) 358-3884
NPI assigned
Jun 1, 2015
Last updated
Oct 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME126913 FL
Internal Medicine Physician 207R00000X 280758 NY
Nephrology Physician 207RN0300X ME126913 FL Primary

Addresses

Primary practice location

929 N US Highway 441 Ste 503
Lady Lake, FL 32159

Mailing address

110 E Berkshire Cir
Longwood, FL 32779-5620
Phone (732) 347-5584

Other practice location 1

3304 SE Lake Weir Ave
Unit# 3
Ocala, FL 34471-8601
Phone (352) 620-9181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160819001487 FL Practitioner - Internal Medicine 2668774621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mohammed a Hossain MD, LLCGroup PAC ID 9436490570, 4 clinicians

Practice addresses (Care Compare)

1451 El Camino Real
The Villages, FL 32159-0041
Phone (352) 578-2486

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.37 of 100Reported as group
Quality
100
Improvement activities
40
Cost
77.89

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mohammed a Hossain MD, LLC Single Specialty CurrentSince Jan 24, 2017 Accepting new patients
Florida Health Care LLC Single Specialty Past Accepting new patients

Locations

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 10

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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1346620770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E BERKSHIRE CIR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795620",
            "telephone_number": "732-347-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 N US HIGHWAY 441 STE 503",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-578-2486",
            "fax_number": "352-358-3884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3304 SE Lake Weir Ave",
            "address_2": "UNIT# 3",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344718601",
            "country_code": "US",
            "telephone_number": "352-620-9181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOSSAIN",
        "first_name": "MOHAMMED",
        "middle_name": "AMZAD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME126913",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "280758",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME126913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.