Individual provider Active NPI

Maged Mehanni, MD

  • Pulmonary Disease Physician
  • Okeechobee, FL
National Provider Identifier
1699716381
Registry record updated Jan 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME0070346 Issued in FL
Practice address
1922 Highway 441 N
Okeechobee, FL 34972-1922
Phone
(863) 763-3622
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0070346 FL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME0070346 FL
Pulmonary Disease Physician 207RP1001X ME0070346 FL Primary

Addresses

Primary practice location

1922 Highway 441 N
Okeechobee, FL 34972-1922

Mailing address

PO Box 205
Okeechobee, FL 34973-0205
Phone (863) 763-3622

Other identifiers 3

IdentifierTypeStateIssuer
250950401MedicaidFL
31790OtherFLBCBS PIN#
ME0070346OtherFLLICENSE

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
I20041004000583 FL Practitioner - Pulmonary DiseasePractitioner - Sleep Medicine 5193784437 Practice locations: Okeechobee, FL

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Sleep Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1922 Hwy 441 N
Okeechobee, FL 34972-1922
Phone (863) 763-3622

1922 US Hwy 441 N
Okeechobee, FL 34972-1922

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0070346FLMDInternal Medicine Physician

Hospital & facility affiliations 2

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1699716381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 205",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349730205",
            "telephone_number": "863-763-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 HIGHWAY 441 N",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349721922",
            "telephone_number": "863-763-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHANNI",
        "first_name": "MAGED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0070346",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME0070346",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME0070346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250950401",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN#",
            "identifier": "31790",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME0070346",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

Verify at the official NPI Registry.