Individual provider Active NPI

Mahnaz Qayyum, MD

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1457338519
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME90009 Issued in FL
Practice address
7932 W Sand Lake Rd Ste 200
Orlando, FL 32819-7299
Phone
(407) 355-7759
Fax
(407) 355-4987
NPI assigned
Dec 29, 2005
Last updated
Dec 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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 ME90009 FL Primary

Addresses

Primary practice location

7932 W Sand Lake Rd Ste 200
Orlando, FL 32819-7299

Mailing address

7932 W Sand Lake Rd Ste 200
Orlando, FL 32819-7299
Phone (407) 355-7759

Other identifiers 1

IdentifierTypeStateIssuer
271227000MedicaidFL

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
I20041123000103 FL Practitioner - Family PracticePractitioner - Geriatric Medicine 5193780856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mahnaz Qayyum Medical Enterprises LLCGroup PAC ID 1658522818, 2 clinicians

Practice addresses (Care Compare)

7932 W Sand Lake Rd
Orlando, FL 32819-7299
Phone (407) 355-7759

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mahnaz Qayyum Medical Enterprises, LLC Family Medicine CurrentSince Jul 15, 2012 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Jan 20, 2019 Accepting new patients

Locations

601 E Altamonte Dr
Altamonte Springs, FL 32701
Phone (407) 303-2200

1530 Celebration Blvd
Ste 408
Celebration, FL 34747
Phone (407) 392-2777

7932 W Sand Lake Rd
Ste 200
Orlando, FL 32819
Phone (407) 355-7759

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.

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1457338519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7932 W SAND LAKE RD STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197299",
            "telephone_number": "407-355-7759",
            "fax_number": "407-355-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7932 W SAND LAKE RD STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197299",
            "telephone_number": "407-355-7759",
            "fax_number": "407-355-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QAYYUM",
        "first_name": "MAHNAZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME90009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271227000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.