Ilyas Gutale, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1776 Issued in NV

Practice address

600 E Dixie Ave
Leesburg, FL 34748-5925

Phone

(352) 323-5762

NPI assigned

Jan 23, 2009

Last updated

Apr 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, VA, FL, NV, WA, NC, MA, MN, TX, CA, AZ, NJ, NY13 enrollments

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 13

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Medexpress Urgent Care of Boynton Beach, LLC

  dba MedExpress Urgent Care - Boynton Beach

  • Urgent Care Clinic/Center
  • Boynton Beach, FL
  • NPI 1366544728
  Medicare reassignment NPD
• Arizona Em-I Medical Services PC

  • Physician Assistant
  • Yuma, AZ
  • NPI 1144768862

  Emergency Medicine

  Medicare reassignment NPD
• Medexpress Urgent Care, PC - Massachusetts

  dba MedExpress Urgent Care - Hadley, Russell St

  • Urgent Care Clinic/Center
  • Hadley, MA
  • NPI 1558882845

  Emergency Medicine

  Medicare reassignment NPD
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment NPD
• Dwic of Tampa Bay, Inc.

  dba MedExpress Urgent Care - Clearwater

  • Urgent Care Clinic/Center
  • Clearwater, FL
  • NPI 1780633834
  Medicare reassignment
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment
• 303 Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Yuma, AZ
  • NPI 1518398585
  Medicare reassignment
• Barron Emergency Physicians LLC

  • Emergency Medicine Physician
  • Manahawkin, NJ
  • NPI 1790736940
  Medicare reassignment
• Clinic Services of California Medical Group Inc

  • Emergency Medicine Physician
  • Lodi, CA
  • NPI 1578958450
  Medicare reassignment
• Eds-I Homansky Practices of Nevada PC

  • Nurse Practitioner
  • Pahrump, NV
  • NPI 1720540628
  Medicare reassignment
• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment
• Evergreen Emergency Services, PS

  • Emergency Medicine Physician
  • Kirkland, WA
  • NPI 1619912524
  Medicare reassignment

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1497993802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485925",
            "telephone_number": "352-323-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485925",
            "telephone_number": "352-323-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTALE",
        "first_name": "ILYAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-23",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053832",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54636",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1776",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9105989",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "PA1776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guions Behavioral Services LLC
• Guions Professional Services LLC
• Debra A Guitz, ARNP
• Ravi P Gupta, M.D.
• Joseph Samuel Gurinsky, M.D.
• Christopher M Habba, PHARMD
• Angela Kristine Hackerott, PTA
• Hannah Haefner
• Demara Hairston, LPTA
• Eric Allen Hall, DO

• Physician Assistant in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.