NPIMap

Individual provider Active NPI

Ahmad Souheil Jalloul, M.D.

  • Pulmonary Disease Physician
  • Clermont, FL
National Provider Identifier
1740208404
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME97922 Issued in FL
Practice address
3121 Citrus Tower Blvd
Clermont, FL 34711-6881
Phone
(352) 404-5968
Fax
(877) 762-7377
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X ME97922 FL
Pulmonary Disease Physician 207RP1001X ME97922 FL Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME97922 FL

Addresses

Primary practice location

3121 Citrus Tower Blvd
Clermont, FL 34711-6881

Mailing address

PO Box 386
Tavares, FL 32778-0386
Phone (352) 404-5986

Other identifiers 1

IdentifierTypeStateIssuer
277784300MedicaidFL

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
I20070423000578 FL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 0648229138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Sleep Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2762 Dora Ave
Tavares, FL 32778-4970
Phone (352) 404-5968

Hospital & facility affiliations

  • HCA Florida Healthcare at Home Home health agency, The Villages, FL, CCN 109581
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME97922FLMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Critical Care & Sleep Specialists of Lake County, PA Pulmonary Disease CurrentSince Apr 1, 2007 Accepting new patients
David C. Rioux, D.O. Past Accepting new patients
Hospitalist Medicine Physicians of Rapides Parish, LLC Past Accepting new patients

Locations

3121 Citrus Tower Blvd
Clermont, FL 34711
Phone (308) 379-3079

2762 Dora Ave
Tavares, FL 32778
Phone (352) 404-5968

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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 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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1740208404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 386",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327780386",
            "telephone_number": "352-404-5986",
            "fax_number": "877-762-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 CITRUS TOWER BLVD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116881",
            "telephone_number": "352-404-5968",
            "fax_number": "877-762-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALLOUL",
        "first_name": "AHMAD",
        "middle_name": "SOUHEIL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "FL",
            "license": "ME97922",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME97922",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME97922",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277784300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.