Individual provider Active NPI

Ronald C. Mallonee, D.O.

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1417989633
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS6833 Issued in FL
Practice address
632 N Semoran Blvd
Orlando, FL 32807-3330
Phone
(407) 205-3132
NPI assigned
Jul 7, 2006
Last updated
Sep 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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 OS6833 FL Primary

Addresses

Primary practice location

632 N Semoran Blvd
Orlando, FL 32807-3330

Mailing address

632 N Semoran Blvd
Orlando, FL 32807-3330
Phone (407) 205-3132

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
I20081211000338 FL Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 2466424676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

822 Lake Baldwin LN
Orlando, FL 32803-4323
Phone (407) 720-1843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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 Osteopathy

State licenses

LicenseStateTypeSpecialty
OS6833FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Orlando Family Medicine Associates PA Family Medicine PastSince Nov 12, 1997 Accepting new patients
Waterford Park Family Medicine Family Medicine PastSince Apr 30, 2003 Accepting new patients

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, 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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1417989633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 N SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073330",
            "telephone_number": "407-205-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 N SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073330",
            "telephone_number": "407-205-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLONEE",
        "first_name": "RONALD",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS6833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.