Individual provider Active NPI

Gayle D Feliciano, M.D.

  • Internal Medicine Physician
  • Miramar, FL
National Provider Identifier
1780696310
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME83446 Issued in FL
Practice address
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Phone
(954) 399-4642
Fax
(877) 859-8768
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME83446 FL
Internal Medicine Physician 207R00000X ME83446 FL Primary

Addresses

Primary practice location

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308

Mailing address

14103 Pipevine CT
Winter Garden, FL 34787-5472
Phone (407) 925-6998

Other identifiers 1

IdentifierTypeStateIssuer
2700954600MedicaidFL

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
I20041029000111 FL Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Peripheral Vascular Disease 9335101625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Peripheral Vascular Disease
Education
Medical University of South Carolina College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

251 E Florida Ave
Melbourne, FL 32901-8303
Phone (866) 877-7123

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue321
Removal of skin lesions32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Post Acute Care Clinicians, LLC Family Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

5888 Blanding Blvd
Jacksonville, FL 32244
Phone (904) 612-7385

251 E Florida Ave
Melbourne, FL 32901
Phone (321) 725-3900

3033 Sarno Rd
Melbourne, FL 32934
Phone (321) 243-8593

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

1780 N Jefferson Hwy
Monticello, FL 32344
Phone (800) 708-4008

1800 NE 168th St
North Miami Beach, FL 33162
Phone (305) 917-1800

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.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1780696310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14103 PIPEVINE CT",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875472",
            "telephone_number": "407-925-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "954-399-4642",
            "fax_number": "877-859-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIANO",
        "first_name": "GAYLE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME83446",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME83446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2700954600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.