Individual provider Active NPI

Youssef B Ghaly, M.D.

  • Family Medicine Physician
  • Lakeland, FL
National Provider Identifier
1770580334
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME-82770 Issued in FL
Practice address
6030 S Florida Ave Ste 110
Lakeland, FL 33813-3351
Phone
(863) 644-9800
Fax
(863) 644-9822
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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 ME-82770 FL Primary

Addresses

Primary practice location

6030 S Florida Ave Ste 110
Lakeland, FL 33813-3351

Mailing address

St Lukes Regional Health Care PLC
6030 S Florida Avenue, Suite 110
Lakeland, FL 33813
Phone (863) 644-9800

Other practice location 1

St Lukes Regional Health Care PLC
6030 S Florida AV, Ste 110
Lakeland, FL 33813
Phone (863) 644-9800

Other identifiers 1

IdentifierTypeStateIssuer
2626292-00MedicaidFL

Other names 1

  • Dr. Joseph B. Ghaly Other name

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
I20070417000120 FL Practitioner - Family Practice 1658476809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6030 S Florida Ave
Suite 110
Lakeland, FL 33813-3301
Phone (863) 644-9800

Hospital & facility affiliations

  • Baycare Home Care Inc Home health agency, Lakeland, FL, CCN 107282

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME-82770FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Regional Health Care PLC Family Medicine CurrentSince Apr 17, 2007 Accepting new patients
Bond Urgent Care LLC Past Accepting new patients

Locations

6030 S Florida Ave
Ste 110
Lakeland, FL 33813
Phone (863) 644-9800

Interoperability endpoints

  • Direct secure messaging: youssefghaly@fmsfplc.allscriptsdirect.net
  • Direct secure messaging: youssef.ghaly.p1@direct.bondclinicpa.nextgenshare.com

Organizations & group practices 2

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1770580334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ST LUKES REGIONAL HEALTH CARE PLC",
            "address_2": "6030 S FLORIDA AVENUE, SUITE 110",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33813",
            "telephone_number": "863-644-9800",
            "fax_number": "863-644-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 S FLORIDA AVE STE 110",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133351",
            "telephone_number": "863-644-9800",
            "fax_number": "863-644-9822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "St Lukes Regional Health Care PLC",
            "address_2": "6030 S Florida AV, Ste 110",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "33813",
            "country_code": "US",
            "telephone_number": "863-644-9800",
            "fax_number": "863-644-9822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHALY",
        "first_name": "YOUSSEF",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME-82770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2626292-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSEPH",
            "last_name": "GHALY",
            "middle_name": "B.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.