Individual provider Active NPI

Neil George Grant Asthana, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Walton Beach, FL
National Provider Identifier
1669645651
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME1033096 Issued in FL
Practice address
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone
(850) 863-7660
NPI assigned
Apr 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME1033096 FL Primary

Addresses

Primary practice location

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Mailing address

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone (850) 863-7660

Other identifiers 1

IdentifierTypeStateIssuer
001027500MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100126000226 FL Practitioner - Pathology 3072655299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone (850) 863-7563

Hospital & facility affiliations

  • HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223
  • HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME1033096FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Dec 15, 2018 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

2190 Highway 85 N
Niceville, FL 32578
Phone (850) 678-4131

11375 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 596-4209

Organizations & group practices 1

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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1669645651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-863-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-863-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASTHANA",
        "first_name": "NEIL",
        "middle_name": "GEORGE GRANT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME1033096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001027500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.