Individual provider Active NPI

Nicole I Gomez Dorati

  • Gastroenterology Physician
  • Kissimmee, FL
National Provider Identifier
1558775791
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME135373 Issued in FL
Practice address
2400 N Orange Blossom TRL Ste 302
Kissimmee, FL 34744-2308
Phone
(407) 932-6193
Fax
(407) 932-6194
NPI assigned
Jun 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X ME135373 FL Primary

Addresses

Primary practice location

2400 N Orange Blossom TRL Ste 302
Kissimmee, FL 34744-2308

Mailing address

2400 N Orange Blossom TRL Ste 302
Kissimmee, FL 34744-2308
Phone (407) 932-6193

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
I20181022002379 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 8022361070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2400 N Orange Blossom TRL
Suite 302
Kissimmee, FL 34744-2308
Phone (407) 932-6193

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy30
Upper gastrointestinal (GI) endoscopy for acid reflux30

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 17, 2018 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 17, 2018 Accepting new patients

Locations

2400 N Orange Blossom Trl
Ste 302
Kissimmee, FL 34744
Phone (407) 932-6193

2488 E Irlo Bronson Memorial Hwy
Ste 202
Kissimmee, FL 34744

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 2

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": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1558775791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL STE 302",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442308",
            "telephone_number": "407-932-6193",
            "fax_number": "407-932-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL STE 302",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442308",
            "telephone_number": "407-932-6193",
            "fax_number": "407-932-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ DORATI",
        "first_name": "NICOLE",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME135373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.