Individual provider Active NPI

Neal R Mortensen, DPM

  • Podiatrist
  • Altamonte Springs, FL
National Provider Identifier
1922081645
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO3214 Issued in FL
Practice address
450 W Central Pkwy Ste 1000
Altamonte Springs, FL 32714-2433
Phone
(321) 397-2699
Fax
(407) 926-0500
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO3214 FL Primary

Addresses

Primary practice location

450 W Central Pkwy Ste 1000
Altamonte Springs, FL 32714-2433

Mailing address

450 W Central Pkwy Ste 1000
Altamonte Springs, FL 32714-2433
Phone (321) 397-2699

Other identifiers 2

IdentifierTypeStateIssuer
65910OtherFLBLUE CROSS BLUE SHIELD
340549400MedicaidFL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025000579 FL Practitioner - Podiatry 5395644579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Podiatry of Central Florida PAGroup PAC ID 1153491535, 7 clinicians

Practice addresses (Care Compare)

697 Douglas Ave
Altamonte Springs, FL 32714-2515
Phone (321) 397-2699

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Orlando, FL, CCN 683131
  • Encompass Health Rehabilitation Hospital of Kissim Inpatient rehabilitation facility, Kissimmee, FL, CCN 103064
  • Select Specialty Hospital - Orlando (South Campus) Long-term care hospital, Orlando, FL, CCN 102003

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue16
Removal of skin lesions1-10
Removal of nail tissue1356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Podiatry of Central Florida PA Podiatrist CurrentSince Oct 19, 2020 Accepting new patients

Locations

697 Douglas Ave
Altamonte Springs, FL 32714
Phone (407) 497-8446

450 W Central Pkwy
Ste 1000
Altamonte Springs, FL 32714
Phone (407) 331-5511

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1922081645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W CENTRAL PKWY STE 1000",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142433",
            "telephone_number": "321-397-2699",
            "fax_number": "407-926-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W CENTRAL PKWY STE 1000",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142433",
            "telephone_number": "321-397-2699",
            "fax_number": "407-926-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "NEAL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "65910",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340549400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.