Individual provider Active NPI

Mustafa Kinaan

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Cloud, FL
National Provider Identifier
1548675655
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME132136 Issued in FL
Practice address
3004 17TH St
Saint Cloud, FL 34769-6011
Phone
(407) 593-2910
Fax
(407) 593-2913
NPI assigned
Jun 26, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X ME132136 FL Primary

Addresses

Primary practice location

3004 17TH St
Saint Cloud, FL 34769-6011

Mailing address

3004 17TH St
Saint Cloud, FL 34769-6011
Phone (407) 593-2910

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
I20200820000494 FL Practitioner - Endocrinology 2769808872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Endocrinology PLLCGroup PAC ID 9234396326, 4 clinicians

Practice addresses (Care Compare)

3004 17TH St
Saint Cloud, FL 34769-6011
Phone 4075932910101

Hospital & facility affiliations

  • HCA Florida Osceola Hospital Hospital, Kissimmee, FL, CCN 100110
  • Orlando Health St Cloud Hospital Hospital, Saint Cloud, FL, CCN 100302
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • HCA Florida Poinciana Hospital Hospital, Kissimmee, FL, CCN 100320

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Endocrinology PLLC Single Specialty CurrentSince Jul 23, 2020 Accepting new patients

Locations

505 W Oak St
Kissimmee, FL 34741
Phone (407) 270-0321

3004 17th St
Saint Cloud, FL 34769
Phone (407) 556-3973

2914 17th St
Saint Cloud, FL 34769
Phone (407) 498-3076

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mustafa.kinaan@hca4.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBFHBA

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1548675655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696011",
            "telephone_number": "407-593-2910",
            "fax_number": "407-593-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696011",
            "telephone_number": "407-593-2910",
            "fax_number": "407-593-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINAAN",
        "first_name": "MUSTAFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-26",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME132136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.