Individual provider Active NPI

Melodie J Mope, M.D.

  • Family Medicine Physician
  • Windermere, FL
National Provider Identifier
1861636649
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME110713 Issued in FL
Practice address
5151 Winter Garden Vineland Rd
Windermere, FL 34786-6098
Phone
(407) 635-3070
Fax
(407) 636-7802
NPI assigned
Apr 24, 2009
Last updated
Feb 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME110713 FL Primary

Addresses

Primary practice location

5151 Winter Garden Vineland Rd
Windermere, FL 34786-6098

Mailing address

5151 Winter Garden Vineland Rd
Windermere, FL 34786-6098
Phone (407) 635-3070

Other identifiers 1

IdentifierTypeStateIssuer
007626000MedicaidFL

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
I20121112000512 FL Practitioner - Family Practice 4880845262 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revitalizing Infusion Therapies, LLCGroup PAC ID 6305236423, 3 clinicians

Practice addresses (Care Compare)

15820 Shaddock Dr
Suite 130
Winter Garden, FL 34787-5776
Phone (407) 401-8855

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Winter Garden Health and Wellness, LLC Family Medicine CurrentSince Jul 16, 2020 Accepting new patients
Revitalizing Infusion Therapies, LLC CurrentSince May 1, 2024 Accepting new patients
Orlando Physicians Network Inc Family Medicine CurrentSince Dec 24, 2017 Accepting new patients
Central Florida Vascular Center, PA Past Accepting new patients

Locations

100 E Dakin Ave
Kissimmee, FL 34741
Phone (321) 442-0192

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

15820 Shaddock Dr
Ste 130
Winter Garden, FL 34787
Phone (407) 401-8855

Organizations & group practices 4

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 5

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": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1861636649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 WINTER GARDEN VINELAND RD",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866098",
            "telephone_number": "407-635-3070",
            "fax_number": "407-636-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 WINTER GARDEN VINELAND RD",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866098",
            "telephone_number": "407-635-3070",
            "fax_number": "407-636-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOPE",
        "first_name": "MELODIE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME110713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007626000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windermere, FL

Sources for this page

Verify at the official NPI Registry.