Active NPI
Kyle S Fallgatter, MD
- Ophthalmology Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME168086
- Practice address
- 2639 Oak St
Jacksonville, FL 32204-4505 - Phone
- (904) 387-5600
- Fax
- (904) 388-0114
- NPI assigned
- Apr 3, 2018
- Last updated
- Aug 21, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 101374 | GA | |
| Ophthalmology Physician | 207W00000X | ME168086 | FL | Primary |
| Retina Specialist (Ophthalmology) Physician | 207WX0107X | ME168086 | FL | |
| Retina Specialist (Ophthalmology) Physician | 207WX0107X | 101374 | GA |
Addresses
Primary practice location
2639 Oak St
Jacksonville, FL 32204-4505
Mailing address
2639 Oak St
Jacksonville, FL 32204-4505
Phone (904) 387-5600
Other practice location 1
50 Leanni Way Unit E5
Palm Coast, FL 32137-4757
Phone (386) 447-1847
Other practice location 2
3120 Glynn Ave
Brunswick, GA 31520-4848
Phone (912) 262-9092
Other practice location 3
2416 Lynndale Rd Ste 201
Fernandina Beach, FL 32034-5230
Phone (904) 997-9202
Other practice location 4
8786 Perimeter Park Blvd
Jacksonville, FL 32216-6347
Phone (904) 997-9202
Other practice location 5
304 Riverside Dr
Waycross, GA 31501-4549
Phone (912) 283-1400
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kfallgatter@floridaretinainstitute.intellechartdirect.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- University of Florida College of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2639 Oak St
Jacksonville, FL 32204-4505
Phone (904) 387-5600
3120 Glynn Ave
Brunswick, GA 31520-4848
Phone (912) 262-9092
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 99
- Promoting interoperability
- 99
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.94 of 100
- Quality
- 61.89
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.58
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Retina Institute James a Staman MD LLC | Ophthalmology | Current | Accepting new patients |
| Retina Vitreous Consultants | Ophthalmology | Current | Accepting new patients |
Locations
950 Glades Rd
Ste 1C
Boca Raton, FL 33431
Phone (305) 294-5504
2416 Lynndale Rd
Ste 201
Fernandina Beach, FL 32034
Phone 9042615741134
6333 N Federal Hwy
Ste 300
Ft Lauderdale, FL 33308
Phone (954) 776-6880
2639 Oak St
Jacksonville, FL 32204
Phone (904) 387-5600
8786 Perimeter Park Blvd
Jacksonville, FL 32216
Phone (904) 997-9202
50 Leanni Way
Unit E5
Palm Coast, FL 32137
Phone (386) 447-1847
2055 Little Rd
Trinity, FL 34655
Phone (727) 376-7820
1370 E Venice Ave
Ste 201
Venice, FL 34285
Phone (941) 480-0500
3120 Glynn Ave
Brunswick, GA 31520
Phone (912) 262-9092
304 Riverside Dr
Waycross, GA 31501
Phone (912) 283-1400
Interoperability endpoints
- kfallgatter@floridaretinainstitute.intellechartdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Retina Group of Florida
- Ophthalmology Physician
- Fort Lauderdale, FL
- NPI 1699773796
GA
-
dba Florida Retina Institute
- Ophthalmology Physician
- Orlando, FL
- NPI 1447328026
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ascension St. Vincent's Riverside
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1134117575
-
dba Ascension St Vincent's Riverside
- Clinical Medical Laboratory
- Jacksonville, FL
- NPI 1669556072
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1588160188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2639 OAK ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322044505",
"telephone_number": "904-387-5600",
"fax_number": "904-996-1446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2639 OAK ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322044505",
"telephone_number": "904-387-5600",
"fax_number": "904-388-0114"
}
],
"practiceLocations": [
{
"address_1": "50 Leanni Way Unit E5",
"address_purpose": "LOCATION",
"city": "Palm Coast",
"state": "FL",
"postal_code": "321374757",
"country_code": "US",
"telephone_number": "386-447-1847",
"fax_number": "386-447-1848",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3120 Glynn Ave",
"address_purpose": "LOCATION",
"city": "Brunswick",
"state": "GA",
"postal_code": "315204848",
"country_code": "US",
"telephone_number": "912-262-9092",
"fax_number": "912-466-0639",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2416 Lynndale Rd Ste 201",
"address_purpose": "LOCATION",
"city": "Fernandina Beach",
"state": "FL",
"postal_code": "320345230",
"country_code": "US",
"telephone_number": "904-997-9202",
"fax_number": "904-997-9205",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8786 Perimeter Park Blvd",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322166347",
"country_code": "US",
"telephone_number": "904-997-9202",
"fax_number": "904-997-9205",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "304 Riverside Dr",
"address_purpose": "LOCATION",
"city": "Waycross",
"state": "GA",
"postal_code": "315014549",
"country_code": "US",
"telephone_number": "912-283-1400",
"fax_number": "912-283-0019",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FALLGATTER",
"first_name": "KYLE",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-03",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "GA",
"license": "101374",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME168086",
"primary": true
},
{
"code": "207WX0107X",
"taxonomy_group": "",
"desc": "Ophthalmology, Retina Specialist",
"state": "FL",
"license": "ME168086",
"primary": false
},
{
"code": "207WX0107X",
"taxonomy_group": "",
"desc": "Ophthalmology, Retina Specialist",
"state": "GA",
"license": "101374",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kfallgatter@floridaretinainstitute.intellechartdirect.net",
"affiliation": "N",
"address_1": "8786 Perimeter Park Blvd",
"city": "Jacksonville",
"state": "FL",
"country_code": "US",
"postal_code": "322166347",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.