NPIMap

Individual provider Active NPI

Gary Montsdeoca, M.D.

  • Specialist
  • Sebring, FL
National Provider Identifier
1508899402
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0024449 Issued in FL
Practice address
4343 Sun N Lake Blvd
Suite B
Sebring, FL 33872-2162
Phone
(863) 382-9100
Fax
(863) 382-8928
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0024449 FL Primary

Addresses

Primary practice location

4343 Sun N Lake Blvd
Suite B
Sebring, FL 33872-2162

Mailing address

4343 Sun N Lake Blvd
Suite B
Sebring, FL 33872-2162
Phone (863) 382-9100

Other names 1

  • Gary Montsdeoca Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080814000616 FL Practitioner - Rheumatology 1759456478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Miami, LM Miller School of Medicine, 1967
Medicare assignment
May accept Medicare assignment
Group practices
Thakkar Patel and Avalos MD'S LLCGroup PAC ID 5294755617, 14 clinicians

Practice addresses (Care Compare)

1009 Sebring Pkwy
Suite 101
Sebring, FL 33870-1616
Phone (863) 385-5179

1009 Sebring Pkwy
Suite 105
Sebring, FL 33870-1648
Phone (863) 382-9100

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Winter Haven, FL, CCN 107534
  • Patients First Home Care LLC Home health agency, Bradenton, FL, CCN 687173
  • Aveanna Home Health Home health agency, Bradenton, FL, CCN 109108
  • Florida Home Health Home health agency, Bradenton, FL, CCN 108049
  • Vitalcaring Group Home health agency, Bradenton, FL, CCN 108003
  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109
  • Palms at Sebring Nursing and Rehabilitation the Nursing home, Sebring, FL, CCN 105037
  • Lake Placid Health and Rehabilitation Center Nursing home, Lake Placid, FL, CCN 105455
  • Vivo Healthcare Sebring Nursing home, Sebring, FL, CCN 105352

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24449FLMDGeneral Practice Dentistry
ME0024449FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Thakkar Patel & Avalos MD'S LLC CurrentSince Mar 1, 2010 Accepting new patients
Gary Montsdeoca MD PA Specialist CurrentSince Jul 25, 2008 Accepting new patients
Goodlife Healthcare, LLC PastSince Mar 1, 2022 Accepting new patients
Sebring Opco LLC PastSince Sep 1, 2023 Accepting new patients

Locations

4343 Sun N Lake Blvd
Ste B
Sebring, FL 33872
Phone (863) 382-9100

1009 Sebring Pkwy
Ste 101
Sebring, FL 33870
Phone (863) 385-5179

1009 Sebring Pkwy
Ste 105
Sebring, FL 33870
Phone (863) 382-9100

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Vivo Healthcare SebringSebring, FL, CCN 105352 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 1, 2023
Sep 1, 2023
The Palms at Sebring Nursing and RehabilitationSebring, FL, CCN 105037 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF		 Jun 18, 2024
Dec 9, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1508899402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 SUN N LAKE BLVD",
            "address_2": "SUITE B",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722162",
            "telephone_number": "863-382-9100",
            "fax_number": "863-382-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 SUN N LAKE BLVD",
            "address_2": "SUITE B",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722162",
            "telephone_number": "863-382-9100",
            "fax_number": "863-382-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTSDEOCA",
        "first_name": "GARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0024449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GARY",
            "last_name": "MONTSDEOCA",
            "credential": "M.D., P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.