NPIMap

Individual provider Active NPI

Laith Adli Al Balbissi, MD

  • Vascular Surgery Physician
  • Orlando, FL
National Provider Identifier
1083878300
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME145283 Issued in FL
Practice address
7236 Stonerock Cir
Orlando, FL 32819-8000
Phone
(321) 841-6444
Fax
(407) 370-5820
NPI assigned
Jul 16, 2008
Last updated
Aug 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X Q5612 TX
Vascular Surgery Physician 2086S0129X ME145283 FL Primary

Addresses

Primary practice location

7236 Stonerock Cir
Orlando, FL 32819-8000

Mailing address

7236 Stonerock Cir
Orlando, FL 32819-8000
Phone (321) 841-6444

Other identifiers 5

IdentifierTypeStateIssuer
352164301MedicaidTX
200606530 AMedicaidOK
63075211MedicaidNM
352164302MedicaidTX
106291400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200706000279 FL Practitioner - Vascular Surgery 6800106261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

7236 Stonerock Cir
Orlando, FL 32819-8000
Phone (321) 841-6047

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal14
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q5612TXMDSurgery Physician
ME145283FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 29, 2020 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 29, 2020 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

7236 Stonerock Cir
Orlando, FL 32819
Phone (407) 354-1202

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lalbalbissi104491@orlandohealth.medalliesdirect.net

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1083878300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7236 STONEROCK CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198000",
            "telephone_number": "321-841-6444",
            "fax_number": "407-370-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7236 STONEROCK CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198000",
            "telephone_number": "321-841-6444",
            "fax_number": "407-370-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL BALBISSI",
        "first_name": "LAITH",
        "middle_name": "ADLI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q5612",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME145283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352164301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200606530 A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63075211",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352164302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106291400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.