Individual provider Active NPI

Michael R Gebauer, MD

  • Family Medicine Physician
  • Apopka, FL
National Provider Identifier
1306930540
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0026923 Issued in FL
Practice address
3191 E Semoran Blvd
Apopka, FL 32703-5943
Phone
(407) 788-6500
Fax
(407) 869-9400
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0026923 FL Primary

Addresses

Primary practice location

3191 E Semoran Blvd
Apopka, FL 32703-5943

Mailing address

917 Rinehart Rd
Ste 1051
Lake Mary, FL 32746-4853
Phone (407) 788-6500

Other identifiers 1

IdentifierTypeStateIssuer
057753700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0026923FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Inpatient Medicine LLC CurrentSince Nov 15, 2016 Accepting new patients

Locations

400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000

917 Rinehart Rd
Ste 1051
Lake Mary, FL 32746
Phone (407) 562-9170

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1306930540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 RINEHART RD",
            "address_2": "STE 1051",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464853",
            "telephone_number": "407-788-6500",
            "fax_number": "407-869-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 E SEMORAN BLVD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035943",
            "telephone_number": "407-788-6500",
            "fax_number": "407-869-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBAUER",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0026923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057753700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.