Individual provider Active NPI

Luis A Gandara, M.D.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Lake Mary, FL
National Provider Identifier
1407050404
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
ME109856 Issued in FL
Practice address
701 Platinum PT
Lake Mary, FL 32746-4871
Phone
(407) 206-4500
Fax
(407) 643-2802
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD 440572 PA
Physical Medicine & Rehabilitation Physician 208100000X 16675 PR
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X ME109856 FL Primary

Addresses

Primary practice location

701 Platinum PT
Lake Mary, FL 32746-4871

Mailing address

701 Platinum PT
Lake Mary, FL 32746-4871
Phone (407) 206-4500

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
I20120524000198 FL Practitioner - Physical Medicine and Rehabilitation 9931392446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1414 Kuhl Ave
Orlando, FL 32806-2008
Phone (407) 841-5111

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 440572PAMDPhysical Medicine & Rehabilitation Physician
ME109856FLMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2020 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2020 Accepting new patients
Medical Rehabilitation, Inc PastSince May 11, 2025 Accepting new patients
Davie Urgent Care LLC Past Accepting new patients

Locations

701 Platinum Pt
Lake Mary, FL 32746
Phone (407) 206-4500

454 Rinehart Rd
Ste 200
Lake Mary, FL 32746

454 Rinehart Rd
Ste 2001
Lake Mary, FL 32746

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1285 Orange Ave
Winter Park, FL 32789
Phone (407) 647-2287

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lgandara@jortho1643.srs-direct.com
  • Direct secure messaging: lgandara26947@orlandohealth.medalliesdirect.net

Organizations & group practices 5

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1407050404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PLATINUM PT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464871",
            "telephone_number": "407-206-4500",
            "fax_number": "407-643-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PLATINUM PT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464871",
            "telephone_number": "407-206-4500",
            "fax_number": "407-643-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDARA",
        "first_name": "LUIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD 440572",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PR",
            "license": "16675",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "FL",
            "license": "ME109856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.