FAWAZ MEDICAL AND SURGICAL CLINIC, LLC
NPI 1801207626
Clinic/Center - Multi-Specialty in Defuniak Springs, FL
About Fawaz Medical And Surgical Clinic, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAWAZ MEDICAL AND SURGICAL CLINIC, LLC (NPI 1801207626) is a healthcare organization registered as a multi-specialty in Defuniak Springs, Florida and active in the NPI registry since May 2014. The organization lists Janna Mauldin, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fawaz Medical And Surgical Clinic, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Fawaz Medical And Surgical Clinic, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Fawaz Medical And Surgical Clinic, LLC's NPI number?
The NPI number for Fawaz Medical And Surgical Clinic, LLC is 1801207626. It was assigned to this organization in the NPPES registry on May 14, 2014.
Where is Fawaz Medical And Surgical Clinic, LLC located?
Fawaz Medical And Surgical Clinic, LLC is located at 962 Us Highway 331 S, Defuniak Springs, FL 32435. The listed phone number is (850) 951-8800.
What is Fawaz Medical And Surgical Clinic, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Fawaz Medical And Surgical Clinic, LLC enrolled in Medicare?
Yes. Fawaz Medical And Surgical Clinic, LLC is registered in the Medicare PECOS enrollment system.
When is Fawaz Medical And Surgical Clinic, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Fawaz Medical And Surgical Clinic, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to Fawaz Medical And Surgical Clinic, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Fawaz Medical And Surgical Clinic, LLC was last updated on May 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Fawaz Medical And Surgical Clinic, Llc · NPI 1801207626
Multi-Specialty organization in Defuniak Springs, Florida. Organization record, active in the CMS NPPES registry since May 14, 2014.
## Identity
- **NPI:** 1801207626 (Entity type: Organization)
- **Enumerated:** May 14, 2014
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Janna Mauldin, OFFICE MANAGER
## Practice location
- **Address:** 962 US HIGHWAY 331 S, Defuniak Springs, FL 32435-3372
- **Phone:** (850) 951-8800
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (General Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 14, 2014
- **Other identifiers:** Medicare UPIN E64361 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1801207626) · Data from the CMS NPPES public registry.