Individual provider Active NPI

Mekdes Ditamo, D.O.

  • Neurology Physician
  • Orlando, FL
National Provider Identifier
1639584709
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OS14666 Issued in FL
Practice address
76 Underwood St Ste 200
Orlando, FL 32806-1110
Phone
(321) 841-2800
Fax
(321) 843-8777
NPI assigned
Jun 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X OS14666 FL Primary
Neurology Physician 2084N0400X DO01407 RI

Addresses

Primary practice location

76 Underwood St Ste 200
Orlando, FL 32806-1110

Mailing address

76 Underwood St # MP67
Orlando, FL 32806-1110
Phone (321) 843-7103

Other practice location 1

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (972) 449-0540

Other practice location 2

76 West Underwood St # Mp67
Orlando, FL 32806-1110
Phone (321) 843-7103

Other identifiers 1

IdentifierTypeStateIssuer
021190500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PA, TX, RI, MI, OH6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20170815003007 FL Practitioner - NeurologyPractitioner - Internal MedicinePractitioner - Emergency Medicine 5890067581 Reassigns benefits to 1 organization
I20250203001051 PA Practitioner - Neurology 5890067581 Reassigns benefits to 1 organization
I20250312000422 TX Practitioner - Neurology 5890067581 Reassigns benefits to 1 organization
I20250313001518 RI Practitioner - Neurology 5890067581 Reassigns benefits to 1 organization
I20250325003684 MI Practitioner - Neurology 5890067581 Reassigns benefits to 1 organization
I20250327000696 OH Practitioner - Neurology 5890067581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Telecare PLLCGroup PAC ID 7810204831, 409 clinicians
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

Spring, TX 77382
Phone (972) 449-0540

20 Powell Ave
Newport, RI 02840-2299
Phone (972) 449-0540

2000 S Palestine St
Athens, TX 75751-5610
Phone (972) 449-0540

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (972) 449-0540

65 Harwich Rd
Providence, RI 02906-4919
Phone (972) 449-0540

746 Jefferson Ave
Scranton, PA 18510-1624
Phone (972) 449-0540

76 W Underwood St
Suite 200
Orlando, FL 32806-1110
Phone (321) 841-2800

8 Osprey Dr
Mountain Top, PA 18707-9630
Phone (972) 449-0540

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC Multi-Specialty CurrentSince Jan 1, 2025 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

52 Underwood St
#80
Orlando, FL 32806
Phone (321) 841-3581

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mditamo1310596@ahs.direct-ci.com
  • Direct secure messaging: mditamo25980@orlandohealth.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1759190400000",
    "number": "1639584709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 UNDERWOOD ST # MP67",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "321-843-7103",
            "fax_number": "321-843-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 UNDERWOOD ST STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "321-841-2800",
            "fax_number": "321-843-8777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "972-449-0540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "76 West Underwood St # Mp67",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061110",
            "country_code": "US",
            "telephone_number": "321-843-7103",
            "fax_number": "321-843-8777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DITAMO",
        "first_name": "MEKDES",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "OS14666",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "RI",
            "license": "DO01407",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021190500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.