NPIMap

Individual provider Active NPI

Andrew William Gamenthaler, M.D.

  • Surgery Physician
  • Daytona Beach, FL
National Provider Identifier
1144414558
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
002794 Issued in GA
Practice address
1890 Lpga Blvd
Suite 250
Daytona Beach, FL 32117-7130
Phone
(386) 274-0250
Fax
(386) 274-0269
NPI assigned
Aug 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 002794 GA Primary

Addresses

Primary practice location

1890 Lpga Blvd
Suite 250
Daytona Beach, FL 32117-7130

Mailing address

11945 San Jose Blvd
BLDG 300
Jacksonville, FL 32223-1613
Phone (904) 396-1725

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
I20120725000378 FL Practitioner - General Surgery 8022274745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

1890 Lpga Blvd
Suite 250
Daytona Beach, FL 32117-7131
Phone (386) 274-0250

Hospital & facility affiliations

  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045
  • Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072

Merit-based Incentive Payment System (MIPS)

Final score
85.17 of 100Reported as individual
Quality
68.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision49
Removal of tissue12
Removal of skin lesions1-10
Skin biopsy28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002794GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc Surgery CurrentSince Aug 17, 2014 Accepting new patients
North Florida Surgeons, PA Surgery CurrentSince Jul 1, 2014 Accepting new patients
North Florida Surgeons, PA CurrentSince Jul 1, 2014 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

103 Memorial Medical Pkwy
Ste 125
Daytona Beach, FL 32117
Phone (386) 274-0250

1890 Lpga Blvd
Ste 250
Daytona Beach, FL 32117
Phone (386) 274-0250

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

836 Prudential Dr
Ste 1001
Jacksonville, FL 32207
Phone (904) 398-0004

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: andrew.gamenthaler.1@9109.direct.athenahealth.com
  • Direct secure messaging: agamenthaler57558@adventhealth.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1144414558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD",
            "address_2": "BLDG 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231613",
            "telephone_number": "904-396-1725",
            "fax_number": "904-399-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD",
            "address_2": "SUITE 250",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177130",
            "telephone_number": "386-274-0250",
            "fax_number": "386-274-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMENTHALER",
        "first_name": "ANDREW",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "002794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.