Individual provider Active NPI

Rachael Leigh Gentry

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1073892436
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
258 S Chickasaw TRL
Suite 201
Orlando, FL 32825-3501
Phone
(407) 303-7399
Fax
(407) 303-7305
NPI assigned
Aug 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Medical Physician Assistant 363AM0700X PA9108099 FL

Addresses

Primary practice location

258 S Chickasaw TRL
Suite 201
Orlando, FL 32825-3501

Mailing address

258 S Chickasaw TRL
Suite 201
Orlando, FL 32825-3501
Phone (407) 303-7399

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160301001286 FL Practitioner - Physician Assistant 5799080602 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Mar 20, 2017 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Mar 20, 2017 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

258 S Chickasaw Trl
Ste 201
Orlando, FL 32825
Phone (407) 303-6626

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Interoperability endpoints

  • Direct secure messaging: rgentry70609@adventhealth.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1073892436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL",
            "address_2": "SUITE 201",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253501",
            "telephone_number": "407-303-7399",
            "fax_number": "407-303-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL",
            "address_2": "SUITE 201",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253501",
            "telephone_number": "407-303-7399",
            "fax_number": "407-303-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "RACHAEL",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-16",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108099",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.