Individual provider Active NPI

Gary David Gottlieb, PA-C

  • Surgical Physician Assistant
  • Atlantis, FL
National Provider Identifier
1659352508
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA2199 Issued in FL
Practice address
451 S Country Club Dr
Atlantis, FL 33462-1239
Phone
(561) 762-6354
Fax
(561) 966-0531
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA2199 FL Primary
Physician Assistant 363A00000X 035803 NY

Addresses

Primary practice location

451 S Country Club Dr
Atlantis, FL 33462-1239

Mailing address

451 S Country Club Dr
Atlantis, FL 33462-1239
Phone (561) 762-6354

Other identifiers 1

IdentifierTypeStateIssuer
000969400MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090720000289 FL Practitioner - Physician Assistant 9335291533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Jan 26, 2026 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 26, 2026 Accepting new patients
Stuart Cardiovascular Anesthesia Associates PLLC PastSince Jul 31, 2006 Accepting new patients
Stuart Cardiovascular Associates, PLLC PastSince Jul 31, 2006 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gary.gottlieb.1@26289.direct.athenahealth.com

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 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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1659352508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 S COUNTRY CLUB DR",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621239",
            "telephone_number": "561-762-6354",
            "fax_number": "561-966-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 S COUNTRY CLUB DR",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621239",
            "telephone_number": "561-762-6354",
            "fax_number": "561-966-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "GARY",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA2199",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "035803",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000969400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

Verify at the official NPI Registry.