Organization Active NPI

GK Bansal Rheumatology PLLC

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1275396608
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GK BANSAL RHEUMATOLOGY PLLC
Practice address
7932 W Sand Lake Rd Ste 200
Orlando, FL 32819-7299
Phone
(407) 355-7759
Fax
(407) 355-4987
NPI assigned
Jan 30, 2024
Last updated
Jan 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Mr. Farhan Shah
Title
Manager
Phone
(239) 444-8185

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X

Addresses

Primary practice location

7932 W Sand Lake Rd Ste 200
Orlando, FL 32819-7299

Mailing address

12386 State Road 535
Orlando, FL 32836-6701
Phone (407) 355-7759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240320001778 FL Part B Supplier - Clinic/Group Practice 3577900018 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1275396608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12386 STATE ROAD 535",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328366701",
            "telephone_number": "407-355-7759",
            "fax_number": "407-355-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7932 W SAND LAKE RD STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197299",
            "telephone_number": "407-355-7759",
            "fax_number": "407-355-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GK BANSAL RHEUMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "FARHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "239-444-8185",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.