Individual provider Active NPI

Anthony Aulisio, M.D.

  • Dermatology Physician
  • Gainesville, FL
National Provider Identifier
1508829805
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME71815 Issued in FL
Practice address
114 NW 76TH Dr
Gainesville, FL 32607-6652
Phone
(352) 332-4442
Fax
(352) 332-4550
NPI assigned
Apr 8, 2006
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X ME71815 FL
Dermatology Physician 207N00000X ME71815 FL Primary

Addresses

Primary practice location

114 NW 76TH Dr
Gainesville, FL 32607-6652

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

120 NW 76th Dr
Gainesville, FL 32607-6652
Phone (352) 333-3223

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012001338 FL Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 5597664334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Medical College of Ohio, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

114 NW 76TH Dr
Gainesville, FL 32607-6652
Phone (352) 332-4442

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision202
Removal of skin lesions2355
Removal of skin cancer977
Removal or shaving of skin growth28
Skin biopsy1013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME71815FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology CurrentSince Nov 20, 2020 Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Nov 20, 2020 Accepting new patients
Forefront Dermatology, S.C. Dermatology Current Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients

Locations

114 NW 76th Dr
Gainesville, FL 32607
Phone (352) 332-4442

120 NW 76th Dr
Gainesville, FL 32607
Phone (352) 333-3223

2202 State Ave
Ste 102
Panama City, FL 32405
Phone (850) 250-5790

540 Fontaine St
Pensacola, FL 32503
Phone (800) 243-7546

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: anthony.aulisio@forefrontdermatology.emadirect.md

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1508829805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 NW 76TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326076652",
            "telephone_number": "352-332-4442",
            "fax_number": "352-332-4550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 NW 76th Dr",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326076652",
            "country_code": "US",
            "telephone_number": "352-333-3223",
            "fax_number": "352-332-4550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AULISIO",
        "first_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME71815",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME71815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.