Individual provider Active NPI

Sally Bang

  • Student in an Organized Health Care Education/Training Program
  • Ocala, FL
National Provider Identifier
1366204091
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
7350 SW 60TH Ave Ste 2
Ocala, FL 34476-6476
Phone
(352) 854-5530
NPI assigned
Jan 29, 2024
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Internal Medicine Physician 207R00000X PA9118866 FL

Addresses

Primary practice location

7350 SW 60TH Ave Ste 2
Ocala, FL 34476-6476

Mailing address

18574 Fieldbrook St
Rowland Heights, CA 91748-4829
Phone (626) 905-1633

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
I20240806002415 FL Practitioner - Physician Assistant 6800333006 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
Absolute Health Internal Medicine and PediatricsGroup PAC ID 6406856103, 12 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

7350 SW 60TH Ave
Suite 2
Ocala, FL 34476-6476
Phone (352) 854-5530

8449 SW Hwy 200
Suite 141
Ocala, FL 34481-9695
Phone (352) 693-3378

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9118866FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Telemedicine Healthcare LLC PastSince Nov 8, 2020 Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1366204091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18574 FIELDBROOK ST",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917484829",
            "telephone_number": "626-905-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 SW 60TH AVE STE 2",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344766476",
            "telephone_number": "352-854-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANG",
        "first_name": "SALLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "PA9118866",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.