NPIMap

Individual provider Active NPI

Alexander C. Mbakwem, M.D.

  • Internal Medicine Physician
  • Lakeland, FL
National Provider Identifier
1780793778
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME92808 Issued in FL
Practice address
1629 Lakeland Hills Blvd
Lakeland, FL 33805
Phone
(863) 687-9333
Fax
(863) 686-0160
NPI assigned
Aug 30, 2006
Last updated
Jan 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME92808 FL Primary

Addresses

Primary practice location

1629 Lakeland Hills Blvd
Lakeland, FL 33805

Mailing address

1629 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-9333

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
I20070425000418 FL Practitioner - Internal Medicine 3072400746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alexander C Mbakwem MD PAGroup PAC ID 1456535590, 2 clinicians

Practice addresses (Care Compare)

1629 Lakeland Hills Blvd
Lakeland, FL 33805-3025
Phone (863) 687-9333

Hospital & facility affiliations

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander C Mbakwem MD PA Internal Medicine CurrentSince Feb 1, 2011 Accepting new patients
Montefiore North Ambulatory Care Center Inc Past Accepting new patients

Locations

1629 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 644-9500

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1780793778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-687-9333",
            "fax_number": "863-686-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-687-9333",
            "fax_number": "863-686-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAKWEM",
        "first_name": "ALEXANDER",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME92808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.