Individual provider Active NPI

Doreen Dale Gall, A.R.N.P.

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1053650507
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3189902 Issued in FL
Practice address
7620 Lake Underhill Rd
Orlando, FL 32822-8223
Phone
(321) 235-0692
Fax
(321) 235-0694
NPI assigned
Feb 4, 2013
Last updated
Dec 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3189902 FL Primary
Hospice Registered Nurse 163WH1000X 3189902 FL

Addresses

Primary practice location

7620 Lake Underhill Rd
Orlando, FL 32822-8223

Mailing address

6318 Plymouth Sorrento Rd
Apopka, FL 32712-5162
Phone (352) 636-8042

Other practice location 1

6318 Plymouth Sorrento Rd
Apopka, FL 32712-5162
Phone (352) 636-8042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130815000576 FL Practitioner - Nurse Practitioner 5698917946 Reassigns benefits to 3 organizations
I20260603000091 NC Practitioner - Nurse Practitioner 5698917946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiatry Consultants of NC PLLCGroup PAC ID 2567871643, 77 clinicians
NP Health of FL LLCGroup PAC ID 2365867165, 11 clinicians

Practice addresses (Care Compare)

218 Laurel Creek CT
Spruce Pine, NC 28777-3134
Phone (828) 765-7312

715 E Dixie Ave
Leesburg, FL 34748-5926
Phone (352) 728-3020

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3189902FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shakti Narain MD PA CurrentSince Jan 3, 2022 Accepting new patients
Jacob Medical Associates LLC CurrentSince Jan 22, 2018 Accepting new patients
NP Health of FL LLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

151 E Minnehaha Ave
Clermont, FL 34711
Phone (352) 394-2188

4842 SW Archer Rd
Gainesville, FL 32608
Phone (352) 367-9700

13838 N US Highway 441
Lady Lake, FL 32159
Phone (352) 323-8868

1070 Flagler Ave
Leesburg, FL 34748
Phone (352) 365-2550

700 N Palmetto St
Leesburg, FL 34748
Phone (352) 323-2400

715 E Dixie Ave
Leesburg, FL 34748
Phone (352) 326-7999

14155 Town Loop Blvd
Orlando, FL 32837
Phone (407) 234-0670

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22130/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHDJBA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1053650507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6318 PLYMOUTH SORRENTO RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327125162",
            "telephone_number": "352-636-8042",
            "fax_number": "407-814-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228223",
            "telephone_number": "321-235-0692",
            "fax_number": "321-235-0694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6318 Plymouth Sorrento Rd",
            "address_purpose": "LOCATION",
            "city": "Apopka",
            "state": "FL",
            "postal_code": "327125162",
            "country_code": "US",
            "telephone_number": "352-636-8042",
            "fax_number": "407-814-7759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALL",
        "first_name": "DOREEN",
        "middle_name": "DALE",
        "name_prefix": "Mrs.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "3189902",
            "primary": true
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "FL",
            "license": "3189902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.