NPIMap

Organization Active NPI

Gastroenterology Associates of Pensacola PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
National Provider Identifier
1861535403
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
GASTROENTEROLOGY ASSOCIATES OF PENSACOLA PA
Practice address
517 Selina St
Pensacola, FL 32503-2133
Phone
(850) 436-4563
Fax
(850) 478-7941
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Alan Oliver, CEO
Title
Ceo
Phone
(786) 530-3820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

517 Selina St
Pensacola, FL 32503-2133

Mailing address

9500 S Dadeland Blvd Ste 200
Miami, FL 33156-2866
Phone (305) 468-4185

Other identifiers 2

IdentifierTypeStateIssuer
529932280MedicaidAL
254428810MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040726000423 FL Part B Supplier - Clinic/Group Practice 2365422664 Receives reassigned benefits from 122 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Navarre, FL; Pensacola, FL; Pace, FL; Milton, FL; Jay, FL; Gulf Breeze, FL; Crestview, FL
O20041027000186 AL Part B Supplier - Clinic/Group Practice 2365422664 Receives reassigned benefits from 11 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atmore, AL; Brewton, AL; Foley, AL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1066186Gastroenterology Associates of Pensacola PA517 E Selina St, Pensacola, FL 32503AccreditationMay 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Gastroent Aso of Pensac25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

4485 Woodbine Rd
Pace, FL 32571

5147 N 9th Ave
Ste 311
Pensacola, FL 32504

Practitioners & affiliated clinicians

Practitioners 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1861535403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 S DADELAND BLVD STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562866",
            "telephone_number": "305-468-4185",
            "fax_number": "850-478-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 SELINA ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032133",
            "telephone_number": "850-436-4563",
            "fax_number": "850-478-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY ASSOCIATES OF PENSACOLA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-530-3820",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529932280",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254428810",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (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.