NPIMap

Organization Active NPI

Advanced Gastroenterology Health Care Centers

  • Gastroenterology Physician
  • Port Orange, FL
National Provider Identifier
1790790277
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
ADVANCED GASTROENTEROLOGY HEALTH CARE CENTERS
Practice address
1690 Dunlawton Ave
Suite 210
Port Orange, FL 32127-8980
Phone
(386) 763-4920
Fax
(386) 763-4939
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Dr. Ammar Hemaidan, MDNPI 1033149752
Title
Medical Director
Phone
(386) 763-4920

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1690 Dunlawton Ave
Suite 210
Port Orange, FL 32127-8980

Mailing address

1690 Dunlawton Ave Ste 210
Port Orange, FL 32127-8980
Phone (386) 763-4920

Other practice location 1

1690 Dunlawton Ave Ste 230
Port Orange, FL 32127-8980
Phone (386) 763-4920

Other practice location 2

1890 Lpga Blvd Ste 270
Daytona Beach, FL 32117-7131
Phone (386) 763-4920

Other identifiers 2

IdentifierTypeStateIssuer
267121200MedicaidFL
45571OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220000397 FL Part B Supplier - Clinic/Group Practice 9830084508 Receives reassigned benefits from 7 practitioners
Practice locations: Daytona Beach, FL; Port Orange, FL

National Provider Directory

National Provider Directory

Locations

1890 Lpga Blvd
Ste 270
Daytona Beach, FL 32117
Phone (386) 763-4920

239 N Ridgewood Ave
Ste 1A
Edgewater, FL 32132
Phone (386) 763-4920

2777 Enterprise Rd
Ste 5
Orange City, FL 32763
Phone (386) 763-4920

315 Palm Coast Pkwy NE
Ste 5
Palm Coast, FL 32137
Phone (386) 763-4920

1690 Dunlawton Ave
Ste 210
Port Orange, FL 32127
Phone (386) 763-4920

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1790790277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 DUNLAWTON AVE STE 210",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278980",
            "telephone_number": "386-763-4920",
            "fax_number": "386-763-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 DUNLAWTON AVE",
            "address_2": "SUITE 210",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278980",
            "telephone_number": "386-763-4920",
            "fax_number": "386-763-4939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1690 Dunlawton Ave Ste 230",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321278980",
            "country_code": "US",
            "telephone_number": "386-763-4920",
            "fax_number": "386-763-4939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1890 Lpga Blvd Ste 270",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321177131",
            "country_code": "US",
            "telephone_number": "386-763-4920",
            "fax_number": "386-763-4920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED GASTROENTEROLOGY HEALTH CARE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "HEMAIDAN",
        "authorized_official_first_name": "AMMAR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "386-763-4920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267121200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "45571",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.