Vishal R Panchal, M.D. – Family Medicine Physician

Key facts

NPI: 1720662000
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: ME165915 (FL)
Practice address: 3535 Little Rd
Trinity, FL 34655-1811
Phone: (727) 375-0848
Fax: (727) 375-5548
NPI assigned: May 12, 2021
Sex: Male
Sole proprietor: No

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.

Apollo Medical Group PA Internal Medicine Physician · Trinity, FL · NPI 1619167111

Medicare reassignment Care Compare group NPD FL

Hospital & facility affiliations 1

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

Morton Plant Hospital Association Inc General Acute Care Hospital · Clearwater, FL · NPI 1376529743

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Family Practice
Education: Other, 2004
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Apollo Medical Group PA (8 clinicians)

Practice addresses (Care Compare)

3535 Little Rd
Trinity, FL 34655-1811
Phone (727) 375-0848

Hospital & facility affiliations

Morton Plant Hospital Hospital · Clearwater, FL · CCN 100127

Medicare participation

Medicare fee-for-service enrollment: Enrolled in FL
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20240315001673	FL	Practitioner - Family Practice	4486051265	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles (1 of 3)

Organization	Specialty	Status	New patients
Apollo Medical Group PA		Current since Mar 12, 2024	Accepting new patients

Locations

1831 N Belcher Rd
Ste G1
Clearwater, FL 33765
Phone (727) 724-6300

3535 Little Rd
Trinity, FL 34655
Phone (727) 375-0848

Networks

Optimum HealthCare HMO Network
Freedom Health HMO Network

Interoperability endpoints

FHIR API: https://fhir4.healow.com/fhir/r4/GJGABA

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	ME165915	FL	Yes

Addresses

Primary practice location

3535 Little Rd
Trinity, FL 34655-1811

Mailing address

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 387-1097

Other practice location 1

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 387-1097

Other providers in Trinity, FL

All providers in Trinity, FL · Family Medicine Physician in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.