NPIMap

Individual provider Active NPI

Jean Bernard Le Gall, P.A.

  • Physician Assistant
  • Pensacola, FL
National Provider Identifier
1982857579
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111202 Issued in FL
Practice address
190 E. Intendencia Street
Suite a-28
Pensacola, FL 32502-5806
Phone
(850) 908-6810
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA9111202 FL Primary

Addresses

Primary practice location

190 E. Intendencia Street
Suite a-28
Pensacola, FL 32502-5806

Mailing address

PO Box 17567
Pensacola, FL 32522-7567

Other practice location 1

126 Missouri Ave
Fort Leonard Wood, MO 65473-8952
Phone (573) 596-0131 ext. 1765

Other identifiers 1

IdentifierTypeStateIssuer
0249870000MedicaidFL

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
I20180612000116 FL Practitioner - Physician Assistant 3678743028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Medical Group LLCGroup PAC ID 9638215734, 258 clinicians

Practice addresses (Care Compare)

9400 University Pkwy
Pensacola, FL 32514-5485

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266

Merit-based Incentive Payment System (MIPS)

Final score
81.01 of 100Reported as group
Quality
62.34
Promoting interoperability
95
Improvement activities
40
Cost
78.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111202FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medical Group LLC CurrentSince Jul 2, 2018 Accepting new patients
Baptist Medical Group LLC CurrentSince Jul 2, 2018 Accepting new patients

Locations

9400 University Pkwy
Ste 409
Pensacola, FL 32514
Phone (850) 994-7256

190 E Intendencia St
Ste A28
Pensacola, FL 32502
Phone (850) 908-6810

190 E Intendencia St
Pensacola, FL 32502

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 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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1982857579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17567",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325227567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E. INTENDENCIA STREET",
            "address_2": "SUITE A-28",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325025806",
            "telephone_number": "850-908-6810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "postal_code": "654738952",
            "country_code": "US",
            "telephone_number": "573-596-0131 x1765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE GALL",
        "first_name": "JEAN",
        "middle_name": "BERNARD",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0249870000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.