NPIMap

Individual provider Active NPI

Walter A Conlan III, MD

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Orlando, FL
National Provider Identifier
1952311870
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
ME70963 Issued in FL
Practice address
55 W Gore St
Orlando, FL 32806-1113
Phone
(321) 841-5469
Fax
(321) 841-7470
NPI assigned
Aug 9, 2006
Last updated
Oct 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME70963 FL
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X ME70963 FL Primary

Addresses

Primary practice location

55 W Gore St
Orlando, FL 32806-1113

Mailing address

55 W Gore St
Orlando, FL 32806-1113
Phone (321) 841-5469

Other identifiers 2

IdentifierTypeStateIssuer
250013030OtherFLRAILROAD MEDICARE
251971200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080107000132 FL Practitioner - Undersea and Hyperbaric MedicinePractitioner - Physical Medicine and RehabilitationPractitioner - Preventive Medicine 6800782889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Undersea and Hyperbaric MedicineAlso: Physical Medicine and Rehabilitation
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1414 Kuhl Ave
Orlando, FL 32806-2008
Phone (407) 841-5111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue476
Removal of skin lesions23
Removal or shaving of skin growth17
Skin biopsy11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70963FLMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2019 Accepting new patients

Locations

515 W State Road 434
Ste 101
Longwood, FL 32750
Phone (407) 767-5843

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

55 W Gore St
Orlando, FL 32806
Phone (321) 841-5469

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: wconlan27338@orlandohealth.medalliesdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1952311870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061113",
            "telephone_number": "321-841-5469",
            "fax_number": "321-841-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W GORE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061113",
            "telephone_number": "321-841-5469",
            "fax_number": "321-841-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLAN",
        "first_name": "WALTER",
        "middle_name": "A",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME70963",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ME70963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "250013030",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251971200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.