Individual provider Active NPI

Mario J Monteleone, PAC

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1962492413
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9100983 Issued in FL
Practice address
7932 W Sand Lake Rd
Suite 202
Orlando, FL 32819-7263
Phone
(407) 846-7546
Fax
(321) 206-5419
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9100983 FL Primary

Addresses

Primary practice location

7932 W Sand Lake Rd
Suite 202
Orlando, FL 32819-7263

Mailing address

PO Box 690609
Orlando, FL 32869-0609
Phone (407) 846-7546

Other identifiers 1

IdentifierTypeStateIssuer
008106200MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110726000443 FL Practitioner - Physician Assistant 4082882642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Dermatology, IncGroup PAC ID 1355334863, 20 clinicians

Practice addresses (Care Compare)

400 Celebration PL
A 120
Celebration, FL 34747-4970
Phone (407) 846-7546

530 Ocoee Commerce Pkwy
Ocoee, FL 34761-4219
Phone (407) 827-7546

7932 W Sand Lake Rd
Suite 202
Orlando, FL 32819-7299
Phone (407) 239-7546

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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 1

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1962492413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690609",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328690609",
            "telephone_number": "407-846-7546",
            "fax_number": "321-206-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7932 W SAND LAKE RD",
            "address_2": "SUITE 202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197263",
            "telephone_number": "407-846-7546",
            "fax_number": "321-206-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTELEONE",
        "first_name": "MARIO",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9100983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008106200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.