Johnny Gurgen, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS10423 Issued in FL

Practice address

920 Rolling Acres Rd Unit 203
Lady Lake, FL 32159-5029

Phone

(352) 435-7695

Fax

(352) 435-7453

NPI assigned

Jul 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Dermatology

Education

Oakland College of Medicine and Surgery, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Johnny Gurgen DO PAGroup PAC ID 1355504861, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.29 of 100Reported as group

Quality

90.57

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: jgurgen@drgurgen.emadirect.md
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jgurgen563686@direct.shands.ufl.edu

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.

• Johnny Gurgen DO PA

  • Dermatology Physician
  • Lady Lake, FL
  • NPI 1770856833
  Medicare reassignment Care Compare group NPD Authorized official
• Skin and Cancer Associates

  • Dermatology Physician
  • Plantation, FL
  • NPI 1427017292
  NPD (past)

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1962666966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 ROLLING ACRES RD UNIT 203",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595029",
            "telephone_number": "352-435-7695",
            "fax_number": "352-435-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 ROLLING ACRES RD UNIT 203",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595029",
            "telephone_number": "352-435-7695",
            "fax_number": "352-435-7453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Citizens Blvd",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347483924",
            "country_code": "US",
            "telephone_number": "352-435-7695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GURGEN",
        "first_name": "JOHNNY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "OS10423",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS10423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce P Greene, APRN
• Deborah Lee Gregg, PTA
• Paula Marsh Gregory, D.O.
• Maria-Teresa G Guadagni, OTR L, CHT, MA ED
• Della Grace Guerra, PTA
• Murat Michael Gurgen, ARNP
• Michel S Habashy
• Shannon Elaine Haerter, APRN
• John Mark Hamm, PT
• William M Hammesfahr, MD

• Dermatology Physician in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.