Individual provider Active NPI

Chanteil Deshon Ulatowski, MD

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1386141620
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME148038 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-1134
Phone
(352) 265-5911
NPI assigned
Apr 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME148038 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-1134

Mailing address

PO Box 100186
Gainesville, FL 32610-0186
Phone (352) 265-5911

Other practice location 1

1515 SW Archer Rd
Gainesville, FL 32608-1134
Phone (352) 733-1471

Other practice location 2

1329 SW 16th St
Gainesville, FL 32610-1134
Phone (352) 733-1471

Other identifiers 1

IdentifierTypeStateIssuer
110565600MedicaidFL

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
I20210602000997 FL Practitioner - Emergency Medicine 0648523159 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

17240 Cortez Blvd
Brooksville, FL 34601-8921
Phone (352) 576-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2021 Accepting new patients
W4P LLC Emergency Medicine CurrentSince Jun 15, 2022 Accepting new patients
Tampa General Hospital Current Accepting new patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Jul 13, 2025 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2021 Accepting new patients

Locations

17240 Cortez Blvd
Brooksville, FL 34601
Phone (352) 544-6060

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

6201 N Suncoast Blvd
Crystal River, FL 34428
Phone (352) 527-0671

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1515 SW Archer Rd
Gainesville, FL 32608
Phone (352) 265-0916

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

10461 Quality Dr
Spring Hill, FL 34609
Phone (352) 688-3002

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: culatowski296333@direct.tgh.org

Organizations & group practices 6

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 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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1386141620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100186",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100186",
            "telephone_number": "352-265-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326101134",
            "telephone_number": "352-265-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326081134",
            "country_code": "US",
            "telephone_number": "352-733-1471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1329 SW 16th St",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326101134",
            "country_code": "US",
            "telephone_number": "352-733-1471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ULATOWSKI",
        "first_name": "CHANTEIL",
        "middle_name": "DESHON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME148038",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110565600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.