Avantica Gondi, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME 104474 Issued in FL

Practice address

1818 Harden Blvd Ste 120
Lakeland, FL 33803-1813

Phone

(863) 210-5640

Fax

(863) 210-5716

NPI assigned

Jun 24, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baycare Home Care Inc Home health agency, Lakeland, FL, CCN 107282
• Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lakeland Physicians & Associates, LLC

  • Primary Care Clinic/Center
  • Lakeland, FL
  • NPI 1427429281
  Medicare reassignment NPD
• Clearwater Physicians Group LLC

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1053578914
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baycare Home Care, Inc.

  • Home Health Agency
  • Bradenton, FL
  • NPI 1295728186
  Care Compare affiliation
• Baycare Home Care, Inc.

  • Home Health Agency
  • Lakeland, FL
  • NPI 1952309171
  Care Compare affiliation
• Lakeland Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  Care Compare affiliation

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1063673812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HARDEN BLVD",
            "address_2": "STE 120",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031812",
            "telephone_number": "863-210-5640",
            "fax_number": "863-210-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 HARDEN BLVD STE 120",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031813",
            "telephone_number": "863-210-5640",
            "fax_number": "863-210-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONDI",
        "first_name": "AVANTICA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 104474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001481700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dianelis Gomez
• Leysibet Gomez
• Marcia Gomez, M.D.
• Yvette Jasel Gomez, PMHNP
• Timothy Charles Gompf, MD
• David Gonnella
• Evelynn Gonsalves, LPN
• Esmeralda Gonzales, ARNP
• Maria de Jesus Gonzalez Cruz
• Mary Fernanda Gonzalez Fonseca, RBT-25-411073

• Family Medicine Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.