Individual provider Active NPI

Puja Patel

  • Gastroenterology Physician
  • Port Orange, FL
National Provider Identifier
1306590344
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
PA9118882 Issued in FL
Practice address
6705 Merryvale LN
Port Orange, FL 32128-4044
Phone
(386) 334-9435
NPI assigned
Feb 8, 2022
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Gastroenterology Physician 207RG0100X PA9118882 FL Primary

Addresses

Primary practice location

6705 Merryvale LN
Port Orange, FL 32128-4044

Mailing address

6705 Merryvale LN
Port Orange, FL 32128-4044
Phone (386) 334-9435

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916003550 FL Practitioner - Physician Assistant 4587105762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastro MD Florida, LLCGroup PAC ID 2264432558, 34 clinicians

Practice addresses (Care Compare)

2884 Wellness Ave
Orange City, FL 32763-8427
Phone (386) 668-2221

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Southwest Florida LLC Single Specialty CurrentSince Jan 12, 2026 Accepting new patients
Associates in Digestive Health LLC Single Specialty CurrentSince Jan 12, 2026 Accepting new patients

Locations

835 Currency Cir
Ste 1001
Lake Mary, FL 32746
Phone (407) 749-6656

2884 Wellness Ave
Ste 100
Orange City, FL 32763
Phone (386) 668-2221

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: puja.patel@gog.eclinicaldirectplus.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1306590344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 MERRYVALE LN",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321284044",
            "telephone_number": "386-334-9435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6705 MERRYVALE LN",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321284044",
            "telephone_number": "386-334-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PUJA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "PA9118882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

Verify at the official NPI Registry.