Individual provider Active NPI

Amber Mohlman, PA-C

  • Physician Assistant
  • Maitland, FL
National Provider Identifier
1871289280
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9116724 Issued in FL
Practice address
146 Orange PL
Maitland, FL 32751-6531
Phone
(407) 389-2020
NPI assigned
Apr 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9116724 FL Primary

Addresses

Primary practice location

146 Orange PL
Maitland, FL 32751-6531

Mailing address

146 Orange PL
Maitland, FL 32751-6531

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823002278 FL Practitioner - Physician Assistant 7012370190 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derrow Dermatology Associates LLCGroup PAC ID 0143381863, 4 clinicians

Practice addresses (Care Compare)

146 Orange PL
Maitland, FL 32751-6531
Phone (407) 389-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9116724FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: amohlman@dda.emadirect.md

Organizations & group practices 3

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": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1871289280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 ORANGE PL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 ORANGE PL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516531",
            "telephone_number": "407-389-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHLMAN",
        "first_name": "AMBER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9116724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.