NPIMap

Individual provider Active NPI

David Khosrowzadeh, D.O.

  • Internal Medicine Physician
  • Winter Park, FL
National Provider Identifier
1821438094
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS14019 Issued in FL
Practice address
133 Benmore Dr
Suite 200
Winter Park, FL 32792-4111
Phone
(407) 646-7070
Fax
(407) 646-7747
NPI assigned
Jul 2, 2013
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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 125063642 IL
Internal Medicine Physician 207R00000X OS14019 FL Primary

Addresses

Primary practice location

133 Benmore Dr
Suite 200
Winter Park, FL 32792-4111

Mailing address

133 Benmore Dr
Suite 200
Winter Park, FL 32792-4111
Phone (407) 646-7070

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
I20161111001401 FL Practitioner - Internal Medicine 9032406251 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS14019FLMDInternal Medicine Physician
125063642ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Internal Medicine CurrentSince Feb 28, 2017 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 28, 2017 Accepting new patients
Adventist Health System-Sunbelt, Inc CurrentSince Feb 18, 2017 Accepting new patients
Central Florida Inpatient Medicine LLC Internal Medicine CurrentSince Sep 11, 2016 Accepting new patients
Adventist Health System Sunbelt Inc Internal Medicine CurrentSince Feb 18, 2017 Accepting new patients
Adventist Health System Sunbelt Inc Past Accepting new patients
Adventist Health Systems Sunbelt Inc Past Accepting new patients

Locations

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

917 Rinehart Rd
Ste 1051
Lake Mary, FL 32746
Phone (407) 562-9170

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

7975 Lake Underhill Rd
Ste 200
Orlando, FL 32822
Phone (407) 303-5990

133 Benmore Dr
Ste 200
Winter Park, FL 32792
Phone (407) 599-6060

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dkhosrowzadeh128746@adventhealth.direct-ci.com

Organizations & group practices 7

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 3

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1821438094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR",
            "address_2": "SUITE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-646-7070",
            "fax_number": "407-646-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR",
            "address_2": "SUITE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-646-7070",
            "fax_number": "407-646-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSROWZADEH",
        "first_name": "DAVID",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125063642",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS14019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.