Individual provider Active NPI

Dan Gerstenblitt, MD

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1497807010
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 75029 Issued in FL
Practice address
2420 Lakemont Ave
Orlando, FL 32814-6164
Phone
(407) 716-1861
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

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
Internal Medicine Physician 207R00000X ME 75029 FL Primary

Addresses

Primary practice location

2420 Lakemont Ave
Orlando, FL 32814-6164

Mailing address

4940 Kensington Park Blvd
Orlando, FL 32819-3137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 75029FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Specialists LLC Past Accepting new patients
Internal Medicine Group Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497807010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 KENSINGTON PARK BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328193137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 LAKEMONT AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328146164",
            "telephone_number": "407-716-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSTENBLITT",
        "first_name": "DAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 75029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.