Individual provider Active NPI

Nneamaka Ukatu, MD

  • Dermatology Physician
  • Winter Garden, FL
National Provider Identifier
1972064087
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME162333 Issued in FL
Practice address
1991 Daniels Rd
Winter Garden, FL 34787-4599
Phone
(407) 395-3770
Fax
(407) 395-3779
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME162333 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1991 Daniels Rd
Winter Garden, FL 34787-4599

Mailing address

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-8313

Other practice location 1

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-8313

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
I20230815003789 FL Practitioner - Dermatology 0042549313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York Medical College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The University of Central Florida Board of TrusteesGroup PAC ID 9739181470, 43 clinicians

Practice addresses (Care Compare)

9975 Tavistock Lakes Blvd
Suite 360
Orlando, FL 32827-7665
Phone (407) 266-3627

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision28
Removal of skin lesions276
Removal or shaving of skin growth11
Skin biopsy170

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Central Florida Board of Trustees CurrentSince Mar 1, 2026 Accepting new patients
The University of Central Florida Board of Trustees CurrentSince Mar 1, 2026 Accepting new patients
Florida Institute of Dermatology LLC Dermatology PastSince Jul 2, 2023 Accepting new patients

Locations

3400 Quadrangle Blvd
Orlando, FL 32817
Phone (407) 266-3627

9975 Tavistock Lakes Blvd
Ste 360
Orlando, FL 32827
Phone (407) 266-3627

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1972064087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 DANIELS RD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874599",
            "telephone_number": "407-395-3770",
            "fax_number": "407-395-3779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-8313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UKATU",
        "first_name": "NNEAMAKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME162333",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.