Individual provider Active NPI

Shephali Gandhi, M.D.

  • Internal Medicine Physician
  • Clermont, FL
National Provider Identifier
1598172595
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME156017 Issued in FL
Practice address
1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone
(352) 536-8840
Fax
(352) 536-8841
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.36857 AL
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME156017 FL Primary

Addresses

Primary practice location

1900 Don Wickham Dr
Clermont, FL 34711-1979

Mailing address

1414 Kuhl Ave # MP38
Orlando, FL 32806-2008
Phone (321) 842-4713

Other practice location 1

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 793-8111 ext. 3905

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address providerenrollment@orlandohealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, AL, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20171108000850 NY Practitioner - HospitalistPractitioner - Internal Medicine 1355640103 Reassigns benefits to 1 organization
I20180702001853 AL Practitioner - Internal Medicine 1355640103 Reassigns benefits to 1 organization
I20220804000381 FL Practitioner - Internal Medicine 1355640103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 536-8840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.36857ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Medical Care PC Internal Medicine CurrentSince Sep 13, 2017 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Houston County Healthcare Authority Internal Medicine CurrentSince Apr 25, 2018 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2022 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Houston County Healthcare Authority Internal Medicine Current Accepting new patients
Medcore Associates, PLLC Current Accepting new patients
Pathology Laboratory Associates Current Accepting new patients
Houston County Healthcare Authority Internal Medicine Current Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

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

1414 Kuhl Ave
#38
Orlando, FL 32806
Phone (407) 481-7179

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sgandhi368046@orlandohealth.medalliesdirect.net

Organizations & group practices 9

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 1

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1598172595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 KUHL AVE # MP38",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062008",
            "telephone_number": "321-842-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 Ross Clark Cir",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363013022",
            "country_code": "US",
            "telephone_number": "334-793-8111 x3905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "SHEPHALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.36857",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME156017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "providerenrollment@orlandohealth.com",
            "affiliation": "N",
            "address_1": "1900 Don Wickham Dr",
            "city": "Clermont",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347111979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.