Individual provider Active NPI

Louis Gombkoto, PAC

  • Physician Assistant
  • Ocala, FL
National Provider Identifier
1467470237
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103606 Issued in FL
Practice address
1500 SW 1St Ave
Ocala, FL 34474-4004
Phone
(352) 351-3407
Fax
(352) 351-3407
NPI assigned
Jul 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9103606 FL Primary

Addresses

Primary practice location

1500 SW 1St Ave
Ocala, FL 34474-4004

Mailing address

7101 W Anthony Rd
#89
Ocala, FL 34479-1300
Phone (305) 321-6142

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
I20060306000292 FL Practitioner - Physician Assistant 4587670187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9103606FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet Contracting Services LLC Physician Assistant CurrentSince Apr 1, 2008 Accepting new patients
The Pathology Group of Northwest Florida PLLC Current Accepting new patients
Cep America LLC CurrentSince Mar 13, 2024 Accepting new patients
Cep America LLC CurrentSince Mar 13, 2024 Accepting new patients
Vivid Pathology PA Current Accepting new patients
Holmes County Hospital Corp CurrentSince Sep 1, 2021 Accepting new patients
Blue Wave Emergency Physicians LLC Past Accepting new patients
Pensacola Emergency Physicians, LLC PastSince Feb 9, 2020 Accepting new patients
North Florida Emergency Physicians Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients
Palm Harbor Emergency Physicians Past Accepting new patients
Dolphin Emergency Physicians LLC Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2600 Hospital Dr
Bonifay, FL 32425
Phone (850) 416-6484

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467470237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 W ANTHONY RD",
            "address_2": "#89",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344791300",
            "telephone_number": "305-321-6142",
            "fax_number": "727-507-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SW 1ST AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344744004",
            "telephone_number": "352-351-3407",
            "fax_number": "352-351-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMBKOTO",
        "first_name": "LOUIS",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.