Individual provider Active NPI

Alexander Thomas Nowicki, MD

  • Anesthesiology Physician
  • Gulf Breeze, FL
National Provider Identifier
1265992002
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME170918 Issued in FL
Practice address
1110 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4884
Phone
(850) 469-2044
Fax
(850) 434-4683
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME170918 FL Primary

Addresses

Primary practice location

1110 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4884

Mailing address

PO Box 919374
Orlando, FL 32891-9374
Phone (866) 863-2540

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
I20241213000483 FL Practitioner - Anesthesiology 3476089418 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams of Gulf Breeze LLCGroup PAC ID 9537326665, 38 clinicians

Practice addresses (Care Compare)

1110 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4884
Phone (850) 934-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME170918FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ams of Gulf Breeze LLC Anesthesiology CurrentSince Dec 16, 2024 Accepting new patients
Ams Baptist LLC Anesthesiology CurrentSince Dec 16, 2024 Accepting new patients
Offor Med, Inc. Anesthesiology Past Accepting new patients

Locations

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHAFDD/Endpoint/IHAFDD

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 1

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1265992002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919374",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919374",
            "telephone_number": "866-863-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614884",
            "telephone_number": "850-469-2044",
            "fax_number": "850-434-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWICKI",
        "first_name": "ALEXANDER",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME170918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

Verify at the official NPI Registry.