Organization Active NPI

Afzal Choudhry, MD, P.a

  • Specialist
  • Leesburg, FL
National Provider Identifier
1487060323
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME86954 Issued in FL
Legal business name
AFZAL CHOUDHRY, MD, P.A
Practice address
26218 US Highway 27
Suite 105
Leesburg, FL 34748-1707
Phone
(352) 323-1758
Fax
(352) 323-1894
NPI assigned
Jul 10, 2014
Last updated
Jul 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Authorized official

Name
Donna J Blakemore
Title
Billing MGR
Phone
(352) 323-1758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME86954 FL Primary

Addresses

Primary practice location

26218 US Highway 27
Suite 105
Leesburg, FL 34748-1707

Mailing address

26218 US Highway 27
Suite 105
Leesburg, FL 34748-1707
Phone (352) 323-1758

Other identifiers 1

IdentifierTypeStateIssuer
267916700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141114000232 FL Part B Supplier - Clinic/Group Practice 8426270067 Receives reassigned benefits from 1 practitioner
Practice locations: Leesburg, FL

National Provider Directory

National Provider Directory

Locations

26218 US Highway 27
Ste 105
Leesburg, FL 34748
Phone (352) 323-1758

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405036800000",
    "number": "1487060323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26218 US HIGHWAY 27",
            "address_2": "SUITE 105",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347481707",
            "telephone_number": "352-323-1758",
            "fax_number": "352-323-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26218 US HIGHWAY 27",
            "address_2": "SUITE 105",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347481707",
            "telephone_number": "352-323-1758",
            "fax_number": "352-323-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFZAL CHOUDHRY, MD, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-11",
        "status": "A",
        "authorized_official_last_name": "BLAKEMORE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "352-323-1758"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME86954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267916700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.