Individual provider Active NPI

Mina Mamdouh Zeini, M.D.

  • Family Medicine Physician
  • Titusville, FL
National Provider Identifier
1871566786
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME86118 Issued in FL
Practice address
1250 Grumman Place, Suite B
Titusville, FL 32780
Phone
(321) 269-4240
Fax
(321) 269-5428
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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 ME86118 FL Primary

Addresses

Primary practice location

1250 Grumman Place, Suite B
Titusville, FL 32780

Mailing address

1250 Grumman Place, Suite B
Titusville, FL 32780
Phone (321) 269-4240

Other identifiers 2

IdentifierTypeStateIssuer
LK901OtherFLMEDICARE
269816100MedicaidFL

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
I20040813000605 FL Practitioner - Hospice/Palliative CarePractitioner - Family Practice 8820061344 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME86118FLMDFamily Medicine Physician

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1871566786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 GRUMMAN PLACE, SUITE B",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "32780",
            "telephone_number": "321-269-4240",
            "fax_number": "321-269-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 GRUMMAN PLACE, SUITE B",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "32780",
            "telephone_number": "321-269-4240",
            "fax_number": "321-269-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEINI",
        "first_name": "MINA",
        "middle_name": "MAMDOUH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME86118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "LK901",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269816100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.