Jerry Martin Alstott, MD
Individual provider Active NPI Geriatric Medicine (Family Medicine) Physician · Mount Dora, FL
NPI 1467497271 · NPPES record last updated May 10, 2016
Key facts
- NPI
- 1467497271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- License
- ME0037307 (FL)
- Practice address
- 8030 Saint James Way
Mount Dora, FL 32757-9134 - Phone
- (407) 908-0064
- Fax
- (352) 383-9319
- NPI assigned
- Jun 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Missouri, Kansas City, School of Medicine, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
8030 Saint James Way
Mount Dora, FL 32757-9134
Phone (407) 908-0064
Hospital & facility affiliations
- Beachside Center for Rehabilitation and Nursing
- Harborview Health Center West Altamonte
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120302000282 | FL | Practitioner - Family Practice |
0345409892 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37307 | FL | MD | Pharmacist |
| ME0037307 | FL | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Family Medicine, LLC | Adult Medicine | Current |
Accepting new patients |
| Wekiva Health Care PA LLC | Adult Medicine | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | ME0037307 | FL | |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | ME0037307 | FL | Yes |
Addresses
Primary practice location
8030 Saint James Way
Mount Dora, FL 32757-9134
Mailing address
8030 Saint James Way
Mount Dora, FL 32757-9134
Phone (407) 908-0064
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046349300 | Medicaid | FL |
Other providers in Mount Dora, FL
- Alina Community Center at Mount Dora LLC
- All About Hearing LLC
- Julie L Allen
- Patricia Allen
- Chantal Jenema Alleyne-Simmons
- Jasmine Nicole Ambrosio
- Rhonda Anderson
- Anesthesia and Pain Consultants of Central Florida, LLC
- Angels Around You Home Care LLC
- Angels Home Care of Florida LLC
All providers in Mount Dora, FL · Geriatric Medicine (Family Medicine) Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.