Individual provider Active NPI

Roland Joseph Gincauskas, M. D.

  • Anesthesiology Physician
  • Eglin, FL
National Provider Identifier
1063406775
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME32424 Issued in FL
Practice address
307 Boatner Rd Ste 114
Eglin, FL 32542-1302
Phone
(850) 883-9506
NPI assigned
Sep 8, 2005
Last updated
Feb 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME32424 FL Primary

Addresses

Primary practice location

307 Boatner Rd Ste 114
Eglin, FL 32542-1302

Mailing address

307 Boatner Rd Ste 114
Eglin, FL 32542-1302
Phone (850) 883-9506

Other identifiers 1

IdentifierTypeStateIssuer
038612000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME32424FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peace River Anesthesiology Associates PA Past Accepting new patients
American Medical Care Anesthesiology Past Accepting new patients
The Anesthesia Group, P.a. Anesthesiology Past Accepting new patients

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, 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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1063406775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINCAUSKAS",
        "first_name": "ROLAND",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME32424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038612000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.