Individual provider Active NPI

Imtiaz A Qureshi, MD

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1689687980
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME77164 Issued in FL
Practice address
11183 South Obt
Suite a
Orlando, FL 32837
Phone
(407) 859-8686
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 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 ME77164 FL Primary

Addresses

Primary practice location

11183 South Obt
Suite a
Orlando, FL 32837

Mailing address

11183 South Obt
Suite a
Orlando, FL 32837
Phone (407) 859-8686

Other identifiers 1

IdentifierTypeStateIssuer
256620600MedicaidFL

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
I20101025001407 FL Practitioner - Internal Medicine 0446443238 Reassigns benefits to 2 organizations

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
Family and Internal Medicine Center PAGroup PAC ID 3476746264, 2 clinicians
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

11183 S Orange Blossom TRL
Suite a
Orlando, FL 32837-9402
Phone (407) 859-8686

555 W State Rd
Suite 434
Longwood, FL 32750-5119
Phone (321) 842-2994

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hammond Henry Dist Hospital Current Accepting new patients
Family & Internal Medicine Center PA CurrentSince Sep 21, 2000 Accepting new patients
Central Florida Hospitalist Partners PA Past Accepting new patients

Locations

11183 S Orange Blossom Trl
Ste A
Orlando, FL 32837
Phone (407) 859-8686

600 N College Ave
Geneseo, IL 61254
Phone (309) 944-6431

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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 1

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1689687980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11183 SOUTH OBT",
            "address_2": "SUITE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32837",
            "telephone_number": "407-859-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11183 SOUTH OBT",
            "address_2": "SUITE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32837",
            "telephone_number": "407-859-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "IMTIAZ",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME77164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256620600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.