Individual provider Active NPI

Nicolas Du Fayet de la Tour, DO

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1447900030
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1021938 Issued in MA
Practice address
1329 SW 16TH St Ste 5270
Gainesville, FL 32608-1128
Phone
(352) 733-1471
NPI assigned
Mar 25, 2022
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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
Emergency Medicine Physician 207P00000X 1021938 MA Primary

Addresses

Primary practice location

1329 SW 16TH St Ste 5270
Gainesville, FL 32608-1128

Mailing address

PO Box 100186
Gainesville, FL 32610-0186

Other practice location 1

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250630002674 MA Practitioner - Emergency Medicine 7517470966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Liberty Univ College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of Massachusetts PCGroup PAC ID 4981069580, 44 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of Massachusetts PC Emergency Medicine CurrentSince Aug 11, 2025 Accepting new patients

Locations

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1447900030",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 SW 16TH ST STE 5270",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081128",
            "telephone_number": "352-733-1471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Summer St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016081216",
            "country_code": "US",
            "telephone_number": "508-363-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DU FAYET DE LA TOUR",
        "first_name": "NICOLAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "1021938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.