Individual provider Active NPI

Magdelyn Maldonado

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1871198960
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PACN106 Issued in FL
Practice address
12405 Marleigh CT
Orlando, FL 32828-8650
Phone
(407) 452-7655
NPI assigned
Dec 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 864-P.A. PR
Medical Physician Assistant 363AM0700X PACN106 FL Primary
Family Medicine Physician 207Q00000X TPME1146 FL
Family Medicine Physician 207Q00000X NJDCATEMP-037226 NJ
General Practice Physician 208D00000X HSE36437 FL
Medical Physician Assistant 363AM0700X TPPA672 FL

Addresses

Primary practice location

12405 Marleigh CT
Orlando, FL 32828-8650

Mailing address

12405 Marleigh CT
Orlando, FL 32828-8650
Phone (407) 452-7655

Other practice location 1

460 E Altamonte Dr Ste 2200
Altamonte Springs, FL 32701-4653
Phone (407) 767-0009

Other practice location 2

500 Park Ave
Manalapan, NJ 07726-8375
Phone (732) 679-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12405 Marleigh CT
Orlando, FL 32828-8650

460 E Altamonte Dr
Altamonte Springs, FL 32701-4612

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TPME1146FLMDFamily Medicine Physician
HSE36437FLMDGeneral Practice Physician
PACN106FLMDMedical Physician Assistant
TPPA672FLMDMedical Physician Assistant
864-P.A.PRMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vip Non Emergency Transportation, LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1871198960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12405 MARLEIGH CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288650",
            "telephone_number": "407-452-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12405 MARLEIGH CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288650",
            "telephone_number": "407-452-7655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 E Altamonte Dr Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327014653",
            "country_code": "US",
            "telephone_number": "407-767-0009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Manalapan",
            "state": "NJ",
            "postal_code": "077268375",
            "country_code": "US",
            "telephone_number": "732-679-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "MAGDELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "864-P.A.",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PACN106",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TPME1146",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "NJDCATEMP-037226",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "HSE36437",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "TPPA672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.