Individual provider Active NPI

Magdeley Mordan, MD

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1932757101
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME157941 Issued in FL
Practice address
10987 Sheldon Rd Ste 200
Tampa, FL 33626-4702
Phone
(813) 467-4800
NPI assigned
Aug 29, 2019
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN29896 FL
Family Medicine Physician 207Q00000X ME157941 FL Primary

Addresses

Primary practice location

10987 Sheldon Rd Ste 200
Tampa, FL 33626-4702

Mailing address

10987 Sheldon Rd Ste 200
Tampa, FL 33626-4702
Phone (813) 467-4800

Other practice location 1

3601 Federal Hwy
Miami, FL 33137-3795
Phone (305) 576-6611

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
I20220913004076 FL Practitioner - Family Practice 4284019118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

10987 Sheldon Rd
Suite 200
Tampa, FL 33626-4702
Phone (813) 467-4800

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME157941FLMDFamily Medicine Physician
TRN29896FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Florida Hospital Physician Group Inc Single Specialty CurrentSince Nov 6, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

10987 Sheldon Rd
Ste 200
Tampa, FL 33626
Phone (813) 467-4800

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

Interoperability endpoints

  • Direct secure messaging: mmordan1844283@adventhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1932757101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10987 SHELDON RD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264702",
            "telephone_number": "813-467-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10987 SHELDON RD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264702",
            "telephone_number": "813-467-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331373795",
            "country_code": "US",
            "telephone_number": "305-576-6611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORDAN",
        "first_name": "MAGDELEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN29896",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME157941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.