Individual provider Active NPI

Elizabeth Kentra-Gorey, M.D.

  • Otolaryngology Physician
  • Deerfield Beach, FL
National Provider Identifier
1649212341
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
035919 Issued in GA
Practice address
201 E Sample Rd
Deerfield Beach, FL 33064-3502
Phone
(954) 941-8300
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME130251 FL
Otolaryngology Physician 207Y00000X 035919 GA Primary

Addresses

Primary practice location

201 E Sample Rd
Deerfield Beach, FL 33064-3502

Mailing address

717 Edgemont LN
Park Ridge, IL 60068-2652
Phone (404) 218-2302

Other practice location 1

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 971-6000

Other identifiers 3

IdentifierTypeStateIssuer
023043400MedicaidFL
000531539CMedicaidGA
613724OtherGABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, WI3 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
I20080514000839 GA Practitioner - Otolaryngology 8921177197 Reassigns benefits to 1 organization
I20180601000580 FL Practitioner - Otolaryngology 8921177197 Reassigns benefits to 3 organizations
I20230427002189 WI Practitioner - Otolaryngology 8921177197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2328WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Mar 3, 2018 Accepting new patients
Florida Hospital Physician Group Inc Otolaryngology CurrentSince Jun 12, 2024 Accepting new patients
Carrollton Ear, Nose and Throat, P.C. Otolaryngology CurrentSince Aug 19, 1996 Accepting new patients
Lakeland Regional Health Systems, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Jan 1, 2023 Accepting new patients
The Nemours Foundation Current Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Jan 1, 2023 Accepting new patients
The Nemours Foundation CurrentSince Mar 3, 2018 Accepting new patients
Tanner Medical Group Inc PastSince Jan 1, 2023 Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700

8331 N Davis Hwy
Pensacola, FL 32514
Phone (850) 505-4700

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

150 Clinic Ave
Ste 201
Carrollton, GA 30117
Phone (404) 832-1488

2301 N Lake Dr
Milwaukee, WI 53211
Phone (414) 270-4932

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Interoperability endpoints

  • Direct secure messaging: ekentragorey69271@direct.nemours.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1649212341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 EDGEMONT LN",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682652",
            "telephone_number": "404-218-2302",
            "fax_number": "904-697-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E SAMPLE RD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330643502",
            "telephone_number": "954-941-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 E Fletcher Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336134613",
            "country_code": "US",
            "telephone_number": "813-971-6000",
            "fax_number": "813-615-7542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENTRA-GOREY",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME130251",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "035919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023043400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000531539C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "613724",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.