Individual provider Active NPI

Richard D'Alli, M.D.

  • Child & Adolescent Psychiatry Physician
  • Gainesville, FL
National Provider Identifier
1114080983
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
ME123498 Issued in FL
Practice address
1699 SW 16TH Ave
Gainesville, FL 32608-1158
Phone
(352) 627-9350
NPI assigned
Dec 19, 2006
Last updated
Sep 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X ME123498 FL Primary

Addresses

Primary practice location

1699 SW 16TH Ave
Gainesville, FL 32608-1158

Mailing address

1699 SW 16TH Ave
Gainesville, FL 32608-1158

Other identifiers 1

IdentifierTypeStateIssuer
014807400MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150604002287 FL Practitioner - Psychiatry 4587857743 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME123498FLMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jun 1, 2015 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jun 1, 2015 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

8491 NW 39th Ave
Gainesville, FL 32606
Phone (352) 331-1773

Interoperability endpoints

  • Direct secure messaging: rdalli179981@direct.shands.ufl.edu

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, 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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1114080983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 SW 16TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 SW 16TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081158",
            "telephone_number": "352-627-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ALLI",
        "first_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME123498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014807400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.