Individual provider Active NPI

Sophia Ahmed, M.D.

  • Neurology Physician
  • Port St Lucie, FL
National Provider Identifier
1639209273
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME117243 Issued in FL
Practice address
1700 SE Hillmoor Dr
Port St Lucie, FL 34952-7539
Phone
(772) 335-9600
Fax
(772) 335-7972
NPI assigned
Mar 6, 2007
Last updated
Feb 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 01059127 IN
Neurology Physician 2084N0400X ME117243 FL Primary

Addresses

Primary practice location

1700 SE Hillmoor Dr
Port St Lucie, FL 34952-7539

Mailing address

1700 SE Hillmoor Dr
Port St Lucie, FL 34952-7539
Phone (772) 335-9600

Other identifiers 1

IdentifierTypeStateIssuer
200493960MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SOPHIA.AHMED@hca4.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME117243FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albert C. Lee, M.D., P.C. Neurology PastSince Mar 20, 1997 Accepting new patients
Major Hospital Past Accepting new patients
Ozarks Medical Center Neurology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sophia.ahmed@hca4.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1639209273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527539",
            "telephone_number": "772-335-9600",
            "fax_number": "772-335-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527539",
            "telephone_number": "772-335-9600",
            "fax_number": "772-335-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01059127",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME117243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200493960",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SOPHIA.AHMED@hca4.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1700 SE Hillmoor Dr",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349527539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.