Individual provider Active NPI

Maria Del Carmen Freire, PA

  • Physician Assistant
  • Ocoee, FL
National Provider Identifier
1700392172
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1510 Citrus Medical CT
Ocoee, FL 34761-4547
Phone
(407) 480-4830
Fax
(407) 480-4834
NPI assigned
Dec 21, 2017
Last updated
May 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1510 Citrus Medical CT
Ocoee, FL 34761-4547

Mailing address

10325 Birch Tree LN
Windermere, FL 34786-8021
Phone (407) 951-1677

Other names 1

  • Maria Del Carmen Mandry Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180327001412 FL Practitioner - Physician Assistant 7315209632 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: maria.friere@woendo.directbygreenway.com

Organizations & group practices 1

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": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1700392172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10325 BIRCH TREE LN",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347868021",
            "telephone_number": "407-951-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 CITRUS MEDICAL CT",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614547",
            "telephone_number": "407-480-4830",
            "fax_number": "407-480-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIRE",
        "first_name": "MARIA",
        "middle_name": "DEL CARMEN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "MANDRY",
            "middle_name": "DEL CARMEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.