NPIMap

Individual provider Active NPI

Donald Walter Liebelt, MD

  • Family Medicine Physician
  • Ocala, FL
National Provider Identifier
1710969076
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME56468 Issued in FL
Practice address
3515 SE 17TH St
Ocala, FL 34471
Phone
(352) 509-9165
Fax
(352) 861-7725
NPI assigned
Nov 14, 2005
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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 ME56468 FL Primary

Addresses

Primary practice location

3515 SE 17TH St
Ocala, FL 34471

Mailing address

3515 SE 17TH St
Ocala, FL 34471-5586
Phone (352) 509-9165

Other practice location 1

3515 SE 17th St
Ste 100
Ocala, FL 34471-5586
Phone (352) 509-9165

Other identifiers 1

IdentifierTypeStateIssuer
10600OtherFLBCBS FL

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
I20101015000781 FL Practitioner - Family Practice 7214908540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

3515 SE 17TH St
Suite 100
Ocala, FL 34471-5588
Phone (352) 509-9165

3845 SE Lake Weir Ave
Cora Physical Therapy East Ocala
Ocala, FL 34480-9153
Phone (352) 693-3378

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth12
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Florida Hospital Physician Group Inc Family Medicine CurrentSince Nov 18, 2019 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

3515 SE 17th St
Ste 100
Ocala, FL 34471
Phone (352) 509-9165

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

Interoperability endpoints

  • Direct secure messaging: dliebelt73260@adventhealth.direct-ci.com

Organizations & group practices 3

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 7

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1710969076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715586",
            "telephone_number": "352-509-9165",
            "fax_number": "352-861-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34471",
            "telephone_number": "352-509-9165",
            "fax_number": "352-861-7725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3515 SE 17th St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344715586",
            "country_code": "US",
            "telephone_number": "352-509-9165",
            "fax_number": "352-861-7725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBELT",
        "first_name": "DONALD",
        "middle_name": "WALTER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME56468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "10600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.