Individual provider Active NPI

Abdul R H Mamsa, M.D

  • Neurology Physician
  • Kissimmee, FL
National Provider Identifier
1871764241
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME0051585 Issued in FL
Practice address
820 W Oak St
Kissimmee, FL 34741-6625
Phone
(407) 847-9100
Fax
(407) 847-4412
NPI assigned
Mar 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME0051585 FL Primary

Addresses

Primary practice location

820 W Oak St
Kissimmee, FL 34741-6625

Mailing address

820 W Oak St
Kissimmee, FL 34741-6625
Phone (407) 847-9100

Other identifiers 1

IdentifierTypeStateIssuer
049533600MedicaidFL

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
I20130305000429 FL Practitioner - Neurology 7012162696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

820 W Oak St
Kissimmee, FL 34741-6625

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • HCA Florida Osceola Hospital Hospital, Kissimmee, FL, CCN 100110
  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0051585FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Consultants of Central Florida Inc Neurology CurrentSince Oct 12, 1987 Accepting new patients

Locations

820 W Oak St
Kissimmee, FL 34741
Phone (407) 847-9100

820 W Oak St
Ste 102
Kissimmee, FL 34741

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DAIECA/Endpoint/DAIECA

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.

Hospital & facility affiliations 4

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": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1871764241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347416625",
            "telephone_number": "407-847-9100",
            "fax_number": "407-847-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347416625",
            "telephone_number": "407-847-9100",
            "fax_number": "407-847-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMSA",
        "first_name": "ABDUL",
        "middle_name": "R H",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-13",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME0051585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049533600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.