Organization Active NPI

Herriet V Tupas Levitan MD PA

  • Internal Medicine Physician
  • Winter Park, FL
National Provider Identifier
1366534018
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50502 Issued in FL
Legal business name
HERRIET V TUPAS LEVITAN MD PA
Practice address
1925 Mizell Avenue
Suite #301
Winter Park, FL 32792
Phone
(407) 645-4441
Fax
(407) 645-3242
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Authorized official

Name
Herriet V Tupas Levitan, MD PANPI 1821180779
Title
President
Phone
(407) 645-4441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 50502 FL Primary

Addresses

Primary practice location

1925 Mizell Avenue
Suite #301
Winter Park, FL 32792

Mailing address

PO Box 88
Winter Park, FL 32790
Phone (407) 645-4441

Other identifiers 1

IdentifierTypeStateIssuer
047659500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110119000631 FL Part B Supplier - Clinic/Group Practice 9335328665 Receives reassigned benefits from 1 practitioner
Practice locations: Winter Park, FL

National Provider Directory

National Provider Directory

Locations

2100 Aloma Ave
Ste 202
Winter Park, FL 32792
Phone (407) 214-3051

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278374400000",
    "number": "1366534018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32790",
            "telephone_number": "407-645-4441",
            "fax_number": "407-645-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVENUE",
            "address_2": "SUITE #301",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-645-4441",
            "fax_number": "407-645-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERRIET V TUPAS LEVITAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2010-07-06",
        "status": "A",
        "authorized_official_last_name": "TUPAS LEVITAN",
        "authorized_official_first_name": "HERRIET",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-645-4441",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "50502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047659500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.