Individual provider Active NPI

William Horst Gazzola, D.O.

  • Surgery Physician
  • Orange Park, FL
National Provider Identifier
1982053005
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS19211 Issued in FL
Practice address
1555 Kingsley Ave Ste 503
Orange Park, FL 32073-9207
Phone
(904) 278-5088
NPI assigned
Jun 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X LL39357 SC
Surgery Physician 208600000X OS19211 FL Primary

Addresses

Primary practice location

1555 Kingsley Ave Ste 503
Orange Park, FL 32073-9207

Mailing address

1555 Kingsley Ave Ste 503
Orange Park, FL 32073-9207
Phone (904) 278-5088

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidSC

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
I20221007002026 FL Practitioner - General Surgery 4385048289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of New England, College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

1555 Kingsley Ave
Suite 503
Orange Park, FL 32073-9207
Phone (904) 278-5088

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL39357SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Nov 1, 2022 Accepting new patients
North Florida Surgeons, PA Surgery CurrentSince Nov 1, 2022 Accepting new patients

Locations

1747 Baptist Clay Dr
Ste 240
Fleming Island, FL 32003
Phone (904) 214-8161

836 Prudential Dr
Ste 1001
Jacksonville, FL 32207
Phone (904) 398-0004

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

1747 Baptist Clay Dr
Orange Park, FL 32003
Phone (904) 202-8550

1555 Kingsley Ave
Ste 503
Orange Park, FL 32073
Phone (904) 278-5088

Interoperability endpoints

  • Direct secure messaging: william.gazzola.1@9109.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1982053005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 KINGSLEY AVE STE 503",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320739207",
            "telephone_number": "904-278-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 KINGSLEY AVE STE 503",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320739207",
            "telephone_number": "904-278-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZZOLA",
        "first_name": "WILLIAM",
        "middle_name": "HORST",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL39357",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS19211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.