Organization Active NPI

Platinum Primary Care PLLC

  • Internal Medicine Physician
  • Winter Park, FL
National Provider Identifier
1861007726
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PLATINUM PRIMARY CARE PLLC
Practice address
2071 Dundee Dr
Winter Park, FL 32792-4104
Phone
(347) 681-4136
NPI assigned
Sep 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Authorized official

Name
Asha Tota-Maharaj, MDNPI 1669603601
Title
Owner/Provider
Phone
(347) 681-4136

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2071 Dundee Dr
Winter Park, FL 32792-4104

Mailing address

2071 Dundee Dr
Winter Park, FL 32792-4104
Phone (347) 681-4136

Other names 1

  • Platinum Primary Care PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201028000158 FL Part B Supplier - Clinic/Group Practice 0749690089 Receives reassigned benefits from 1 practitioner
Practice locations: Winter Park, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2194803Platinum Primary Care PLLC2071 Dundee Drive, Winter Park, FL 32792Certificate of waiverOct 1, 2026

National Provider Directory

National Provider Directory

Locations

320 N Edinburgh Dr
Ste B
Winter Park, FL 32792
Phone (407) 951-5348

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1861007726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2071 DUNDEE DR",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924104",
            "telephone_number": "347-681-4136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 DUNDEE DR",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924104",
            "telephone_number": "347-681-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "TOTA-MAHARAJ",
        "authorized_official_first_name": "ASHA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "347-681-4136",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platinum Primary Care PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Platinum Primary Care PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.