NPIMap

Individual provider Active NPI

Asif Mirza

  • Internal Medicine Physician
  • Lake Mary, FL
National Provider Identifier
1588612592
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME78737 Issued in FL
Practice address
2500 W Lake Mary Blvd
Suite 101
Lake Mary, FL 32746-3501
Phone
(407) 936-0976
Fax
(407) 936-0977
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME78737 FL Primary

Addresses

Primary practice location

2500 W Lake Mary Blvd
Suite 101
Lake Mary, FL 32746-3501

Mailing address

1629 Rockdale Loop
Lake Mary, FL 32746-5332
Phone (407) 333-1928

Other identifiers 1

IdentifierTypeStateIssuer
260955000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100319000642 FL Practitioner - Internal Medicine 7719880210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

1401 S Seminole Blvd
Sanford, FL 32771-6743
Phone (407) 321-4500

3030 W Bearss Ave
Tampa, FL 33618-1811
Phone (813) 968-8777

701 W Plymouth Ave
Deland, FL 32720-3236
Phone (386) 943-4522

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Internal Medicine Current Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Sep 8, 2014 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Sep 8, 2014 Accepting new patients
Sebring Emergency Physicians LLC Past Accepting new patients

Locations

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

3600 S Highlands Ave
Sebring, FL 33870
Phone (863) 385-6101

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Organizations & group practices 4

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 8

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1588612592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 ROCKDALE LOOP",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465332",
            "telephone_number": "407-333-1928",
            "fax_number": "407-936-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W LAKE MARY BLVD",
            "address_2": "SUITE 101",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463501",
            "telephone_number": "407-936-0976",
            "fax_number": "407-936-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "ASIF",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME78737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260955000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.