Excel Pediatrics PA

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

ME72542 Issued in FL

Legal business name

EXCEL PEDIATRICS PA

Practice address

265 Citrus Tower Blvd Ste 102
Clermont, FL 34711-1908

Phone

(352) 394-3929

Fax

(352) 394-6446

NPI assigned

Jan 2, 2008

Last updated

Jan 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad Afzal, M.D.NPI 1669411161

Title

Owner

Phone

(352) 394-3929

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972788537. Details of each certification follow.

• CCN 108981 Rural health clinic · Active · Details

Rural health clinic certification: CCN 108981

Legal name

EXCEL PEDIATRICS PA

Doing business as

EXCEL PEDIATRICS

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Apr 29, 2005

Last certification

Feb 14, 2024

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Apr 10, 2001 in FL

Enrollment address

265 Citrus Tower Blvd
Suite 102
Clermont, FL 34711-1908

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mohammad Afzal, MD MBA

  • Pediatrics Physician
  • Clermont, FL
  • NPI 1669411161

  5% Or Greater Direct Ownership Interest, Corporate Director, W-2 Managing Employee

  CMS ownership

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohammad Afzal, MD MBA

  • Pediatrics Physician
  • Clermont, FL
  • NPI 1669411161
  Medicare reassignment NPD Authorized official
• Adam Figliola, ARNP, FNP-BC

  • Family Nurse Practitioner
  • Clermont, FL
  • NPI 1225586696
  NPD (past)
• Suzanne Wallis, FNP-BC

  • Family Nurse Practitioner
  • Clermont, FL
  • NPI 1346603925
  NPD (past)

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1972788537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 CITRUS TOWER BLVD STE 102",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111908",
            "telephone_number": "352-394-3929",
            "fax_number": "352-394-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 CITRUS TOWER BLVD STE 102",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111908",
            "telephone_number": "352-394-3929",
            "fax_number": "352-394-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "AFZAL",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-394-3929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "FL",
            "license": "ME72542",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME72542",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME72542",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660212600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eye Doctors Optical Outlets
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• Eye Specialist of Florida P a (Toppino Eye Care)

• Rural Health Clinic/Center in Clermont, FL
• Providers in Clermont, FL by specialty
• Rural Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.