Organization Active NPI

Lake Howell Family Medicine Associates

  • Family Medicine Physician
  • Maitland, FL
National Provider Identifier
1497713390
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS0003966 Issued in FL
Legal business name
LAKE HOWELL FAMILY MEDICINE ASSOCIATES
Practice address
590 Ruby CT
Maitland, FL 32751-5226
Phone
(407) 677-4867
Fax
(407) 677-4203
NPI assigned
May 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Dr. William Mark Silverman, DONPI 1083619639
Title
Physician Owner
Phone
(407) 677-4867

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS0003966 FL Primary

Addresses

Primary practice location

590 Ruby CT
Maitland, FL 32751-5226

Mailing address

590 Ruby CT
Maitland, FL 32751-5226
Phone (407) 677-4867

Other identifiers 2

IdentifierTypeStateIssuer
373802700MedicaidFL
33370OtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070307000026 FL Part B Supplier - Clinic/Group Practice 9739282047 Receives reassigned benefits from 8 practitioners
Practice locations: Maitland, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0722148Lake Howell Family Medicine Associates590 Ruby CT, Maitland, FL 32751Certificate of waiverNov 30, 2027

National Provider Directory

National Provider Directory

Locations

590 Ruby Ct
Maitland, FL 32751
Phone (407) 677-4867

Practitioners & affiliated clinicians

Practitioners 8

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": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1497713390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 RUBY CT",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515226",
            "telephone_number": "407-677-4867",
            "fax_number": "407-677-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 RUBY CT",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515226",
            "telephone_number": "407-677-4867",
            "fax_number": "407-677-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HOWELL FAMILY MEDICINE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "SILVERMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "407-677-4867",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0003966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373802700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "33370",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.