Active NPI
Ijlal Uddin, M.D.
- Nephrology Physician
- Winter Park, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- ME107810
- Practice address
- 4355 Bear Gully Rd Ste 1024
Winter Park, FL 32792-9422 - Phone
- (407) 288-8750
- Fax
- (407) 647-0616
- NPI assigned
- Mar 4, 2008
- Last updated
- Dec 18, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | MD037977 | DC | |
| Nephrology Physician | 207RN0300X | ME107810 | FL | Primary |
Addresses
Primary practice location
4355 Bear Gully Rd Ste 1024
Winter Park, FL 32792-9422
Mailing address
4355 Bear Gully Rd Ste 1024
Winter Park, FL 32792-9422
Phone (407) 288-8750
Other practice location 1
5745 Canton Cv Ste 121
Winter Springs, FL 32708
Phone (407) 288-8750
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4355 Bear Gully Rd
Suite 1024
Winter Park, FL 32792-9422
Phone (407) 647-2550
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD037977 | DC | MD | Nephrology Physician |
| ME107810 | FL | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Nephrology Hypertension & Renal Transplantation, LLC | Nephrology | Current | Accepting new patients |
| Longwood Medical Group PA | Past | Accepting new patients | |
| Cfa Kidney & Hypertension Center LLC | Past | Accepting new patients |
Locations
174 State Road 436
Unit D102
Casselberry, FL 32707
Phone (407) 551-1601
4355 Bear Gully Rd
Ste 1024
Winter Park, FL 32792
Phone (407) 331-4115
5745 Canton Cv
Ste 121
Winter Springs, FL 32708
Phone (407) 545-6232
Interoperability endpoints
- https://api.platform.athenahealth.com/1577/brand/1/csg/1/fhir/r4
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Nephrology Physician
- Winter Park, FL
- NPI 1366006967
-
- Clinic/Center
- Longwood, FL
- NPI 1538198783
-
- Cardiovascular Disease Physician
- Longwood, FL
- NPI 1235323023
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth Orlando
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
dba AdventHealth Orlando Outreach Laboratory
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734480000000",
"number": "1760652879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4355 BEAR GULLY RD STE 1024",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327929422",
"telephone_number": "407-288-8750",
"fax_number": "407-647-0616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4355 BEAR GULLY RD STE 1024",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327929422",
"telephone_number": "407-288-8750",
"fax_number": "407-647-0616"
}
],
"practiceLocations": [
{
"address_1": "5745 Canton Cv Ste 121",
"address_purpose": "LOCATION",
"city": "Winter Springs",
"state": "FL",
"postal_code": "32708",
"country_code": "US",
"telephone_number": "407-288-8750",
"fax_number": "407-647-0616",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UDDIN",
"first_name": "IJLAL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-04",
"last_updated": "2024-12-18",
"certification_date": "2024-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "DC",
"license": "MD037977",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "FL",
"license": "ME107810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.