Individual provider Active NPI

Glen E Vander Zalm, MD

  • Gastroenterology Physician
  • Orlando, FL
National Provider Identifier
1528033578
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME91815 Issued in FL
Practice address
3885 Oakwater Cir
Orlando, FL 32806-6257
Phone
(407) 851-5600
Fax
(407) 438-9585
NPI assigned
Feb 22, 2006
Last updated
Mar 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME91815 FL Primary

Addresses

Primary practice location

3885 Oakwater Cir
Orlando, FL 32806-6257

Mailing address

3885 Oakwater Cir
Orlando, FL 32806-6257
Phone (470) 851-5600

Other identifiers 3

IdentifierTypeStateIssuer
61788OtherFLBC/BS
271650000MedicaidFL
3743151OtherFLAETNA

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
I20050118000536 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 4385693233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.04 of 100Reported as group
Quality
65.4
Promoting interoperability
98
Improvement activities
40
Cost
76.41

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Dec 22, 2010 Accepting new patients
Gastro Health, LLC Gastroenterology CurrentSince Aug 1, 2018 Accepting new patients
Gastro Health LLC Gastroenterology Current Accepting new patients
Gastro Health, LLC Gastroenterology CurrentSince Aug 1, 2018 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 22, 2010 Accepting new patients

Locations

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

800 N Maitland Ave
Ste 101
Maitland, FL 32751
Phone (407) 660-7150

3661 S Miami Ave
Ste 907
Miami, FL 33133
Phone (305) 856-7333

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

3885 Oakwater Cir
Orlando, FL 32806
Phone (407) 816-5700

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

Networks

  • Optimum HealthCare HMO Network

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1528033578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3885 OAKWATER CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066257",
            "telephone_number": "470-851-5600",
            "fax_number": "407-438-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 OAKWATER CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066257",
            "telephone_number": "407-851-5600",
            "fax_number": "407-438-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER ZALM",
        "first_name": "GLEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME91815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "61788",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271650000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3743151",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.