Individual provider Active NPI

Monique Gupta Kumar, MD

  • Pediatric Dermatology Physician
  • Orlando, FL
National Provider Identifier
1821227133
Registry record updated Oct 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
ME127776 Issued in FL
Practice address
615 E Princeton St Ste 416
Orlando, FL 32803-1469
Phone
(407) 303-1687
Fax
(407) 303-1729
NPI assigned
Jul 8, 2009
Last updated
Oct 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2013012520 MO
Pediatric Dermatology Physician 207NP0225X ME127776 FL Primary

Addresses

Primary practice location

615 E Princeton St Ste 416
Orlando, FL 32803-1469

Mailing address

615 E Princeton St Ste 416
Orlando, FL 32803-1469
Phone (407) 303-1687

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161114002128 FL Practitioner - Dermatology 3173766045 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013012520MOMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 19, 2016 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 19, 2016 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

615 E Princeton St
Ste 416
Orlando, FL 32803
Phone (407) 303-1687

2000 Fowler Grove Blvd
#200
Winter Garden, FL 34787
Phone (407) 303-1444

Interoperability endpoints

  • Direct secure messaging: mkumar73377@adventhealth.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477180800000",
    "number": "1821227133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 416",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031469",
            "telephone_number": "407-303-1687",
            "fax_number": "407-303-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 416",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031469",
            "telephone_number": "407-303-1687",
            "fax_number": "407-303-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "MONIQUE",
        "middle_name": "GUPTA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2016-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2013012520",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "FL",
            "license": "ME127776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.