NPIMap

Individual provider Active NPI

Peter A Ankoh, M.D.

  • Internal Medicine Physician
  • Leesburg, FL
National Provider Identifier
1720044241
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME92546 Issued in FL
Practice address
1107 West Dixie Avenue
Leesburg, FL 34748
Phone
(352) 728-2999
Fax
(352) 460-0050
NPI assigned
Apr 24, 2006
Last updated
Aug 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME92546 FL Primary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X ME92546 FL

Addresses

Primary practice location

1107 West Dixie Avenue
Leesburg, FL 34748

Mailing address

Post Office Box 492530
Leesburg, FL 34749-2530
Phone (352) 728-2999

Other identifiers 1

IdentifierTypeStateIssuer
276086000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051208000162 FL Practitioner - Internal Medicine 3971581695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1107 W Dixie Ave
Leesburg, FL 34748-6311
Phone (352) 728-2999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME92546FLMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peter Amos Ankoh MD PA Internal Medicine CurrentSince Jun 1, 2007 Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia Past Accepting new patients

Locations

1107 W Dixie Ave
Leesburg, FL 34748
Phone (352) 728-2999

709 Physicians Ct
Leesburg, FL 34748
Phone (352) 728-2999

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IABFAD/Endpoint/IABFAD
  • Direct secure messaging: pankoh562416@direct.shands.ufl.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1720044241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 492530",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347492530",
            "telephone_number": "352-728-2999",
            "fax_number": "352-460-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 WEST DIXIE AVENUE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "34748",
            "telephone_number": "352-728-2999",
            "fax_number": "352-460-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANKOH",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME92546",
            "primary": true
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "FL",
            "license": "ME92546",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276086000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.