Organization Active NPI

Gainesville Plastic Surgery Associates PL

  • Plastic and Reconstructive Surgery Physician
  • Gainesville, FL
National Provider Identifier
1659567303
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
GAINESVILLE PLASTIC SURGERY ASSOCIATES PL
Practice address
6801 NW 9TH Blvd
Suite 2
Gainesville, FL 32605-4269
Phone
(352) 331-3401
Fax
(352) 332-0922
NPI assigned
Sep 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

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

Authorized official

Name
Connie Gruenwald
Title
Practice Manager
Phone
(352) 331-3401

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Surgery) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0105X
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

6801 NW 9TH Blvd
Suite 2
Gainesville, FL 32605-4269

Mailing address

6801 NW 9TH Blvd
Suite 2
Gainesville, FL 32605-4269
Phone (352) 331-3401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081030000349 FL Part B Supplier - Clinic/Group Practice 9335208776 Receives reassigned benefits from 2 practitioners
Practice locations: Gainesville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2240581Gainesville Plastic Surgery Associates, PL6801 NW 9TH Blvd, Ste 2, Gainesville, FL 32605Certificate of waiverOct 19, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1659567303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 NW 9TH BLVD",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054269",
            "telephone_number": "352-331-3401",
            "fax_number": "352-332-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 NW 9TH BLVD",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054269",
            "telephone_number": "352-331-3401",
            "fax_number": "352-332-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINESVILLE PLASTIC SURGERY ASSOCIATES PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "GRUENWALD",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "352-331-3401"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.