Individual provider Active NPI

Misbah Fathima Azmath

  • Endocrinology, Diabetes & Metabolism Physician
  • Winter Park, FL
National Provider Identifier
1346771623
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME165638 Issued in FL
Practice address
1111 W Fairbanks Ave Ste 110
Winter Park, FL 32789-4777
Phone
(321) 841-4371
Fax
(407) 936-3866
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME165638 FL Primary
Internal Medicine Physician 207R00000X 072504 CT
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 072504 CT
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1111 W Fairbanks Ave Ste 110
Winter Park, FL 32789-4777

Mailing address

1111 W Fairbanks Ave Ste 110
Winter Park, FL 32789-4777
Phone (321) 841-4371

Other practice location 1

2800 Main St
Bridgeport, CT 06606-4201
Phone (203) 576-6000

Other practice location 2

263 Farmington Ave
Farmington, CT 06030-8025
Phone (860) 679-3245

Other identifiers 1

IdentifierTypeStateIssuer
120527100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mazmath35703@direct.med.uchc.edu

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
I20231206002960 FL Practitioner - EndocrinologyPractitioner - Internal Medicine 0840666541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1111 W Fairbanks Ave
Suite 110
Winter Park, FL 32789-4777
Phone (407) 767-5808

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
072504CTMDInternal Medicine Physician
ME165638FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 1, 2023 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

7472 Docs Grove Cir
Orlando, FL 32819
Phone (407) 241-1037

1111 W Fairbanks Ave
Ste 110
Winter Park, FL 32789
Phone (407) 767-5808

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: misbah.azmath@xdr.hhchealthdirect.org

Organizations & group practices 3

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 3

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1346771623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W FAIRBANKS AVE STE 110",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894777",
            "telephone_number": "321-841-4371",
            "fax_number": "407-936-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W FAIRBANKS AVE STE 110",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894777",
            "telephone_number": "321-841-4371",
            "fax_number": "407-936-3866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Main St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066064201",
            "country_code": "US",
            "telephone_number": "203-576-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060308025",
            "country_code": "US",
            "telephone_number": "860-679-3245",
            "fax_number": "860-679-0121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZMATH",
        "first_name": "MISBAH",
        "middle_name": "FATHIMA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME165638",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "072504",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "072504",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120527100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mazmath35703@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060308025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.