Individual provider Active NPI

Imtiaz Ahmed, M.D.

  • Specialist
  • Kissimmee, FL
National Provider Identifier
1922071158
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0058868 Issued in FL
Practice address
903 W Oak St
Kissimmee, FL 34741-4941
Phone
(407) 846-4000
Fax
(407) 846-4808
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0058868 FL Primary

Addresses

Primary practice location

903 W Oak St
Kissimmee, FL 34741-4941

Mailing address

903 W Oak St
Kissimmee, FL 34741-4941
Phone (407) 846-4000

Other identifiers 1

IdentifierTypeStateIssuer
268025400MedicaidFL

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
I20040329000914 FL Practitioner - Allergy/Immunology 7113819657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3123 Innovation Dr
Saint Cloud, FL 34769-6501
Phone (407) 846-4000

903 W Oak St
Kissimmee, FL 34741-4941
Phone (407) 846-4000

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health St Cloud Hospital Hospital, Saint Cloud, FL, CCN 100302
  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0058868FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Asthma Allergy and Immunology Current Accepting new patients
Asthma Allergy & Immunology PA Specialist CurrentSince Jul 15, 1993 Accepting new patients

Locations

903 W Oak St
Kissimmee, FL 34741
Phone (407) 846-4000

339 Cypress Pkwy
Ste 110
Poinciana, FL 34759
Phone (407) 343-5000

3123 Innovation Dr
Saint Cloud, FL 34769
Phone (407) 846-4000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1922071158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414941",
            "telephone_number": "407-846-4000",
            "fax_number": "407-846-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414941",
            "telephone_number": "407-846-4000",
            "fax_number": "407-846-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "IMTIAZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0058868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268025400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.