NPIMap

Individual provider Active NPI

Gerald R Woodard, D.O.

  • Family Medicine Physician
  • Daytona Beach Shores, FL
National Provider Identifier
1700877388
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS4717 Issued in FL
Practice address
3512 S Atlantic Ave
Daytona Beach Shores, FL 32118-7639
Phone
(386) 767-9544
Fax
(386) 756-0501
NPI assigned
Nov 2, 2005
Last updated
Aug 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS4717 FL Primary

Addresses

Primary practice location

3512 S Atlantic Ave
Daytona Beach Shores, FL 32118-7639

Mailing address

3512 S Atlantic Ave
Daytona Beach Shores, FL 32118-7639
Phone (386) 767-9544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041207000955 FL Practitioner - Family PracticePractitioner - Osteopathic Manipulative MedicinePractitioner - Geriatric MedicinePractitioner - General Practice 8426014044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gerald R Woodard DO PAGroup PAC ID 9436115052, 4 clinicians

Practice addresses (Care Compare)

3512 S Atlantic Ave
Shores Medical Center
Daytona Beach Shores, FL 32118-7639
Phone (386) 767-9544

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.46 of 100Reported as individual
Quality
86.92
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions21
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gerald R Woodard DO PA Current Accepting new patients
Shores Rehab Inc Current Accepting new patients
Counseling & Psychotherapy Centers of FL Past Accepting new patients
Counseling & Psychotherapy Centers of FL Inc Past Accepting new patients
Shores Medical Center Past Accepting new patients

Locations

3512 S Atlantic Ave
Daytona Beach Shores, FL 32118
Phone (386) 767-9544

Interoperability endpoints

  • Direct secure messaging: gerald.woodard.1@3861.direct.athenahealth.com
  • Direct secure messaging: gerald.woodard.do.1@3861.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3861/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186704000000",
    "number": "1700877388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 S ATLANTIC AVE",
            "city": "DAYTONA BEACH SHORES",
            "state": "FL",
            "postal_code": "321187639",
            "telephone_number": "386-767-9544",
            "fax_number": "386-756-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 S ATLANTIC AVE",
            "city": "DAYTONA BEACH SHORES",
            "state": "FL",
            "postal_code": "321187639",
            "telephone_number": "386-767-9544",
            "fax_number": "386-756-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "GERALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2007-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS4717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach Shores, FL

Sources for this page

Verify at the official NPI Registry.