GAUTAM GANGULY - NPI 1669849824 - General Practice in Beverly Hills, FL

Q: What is the provider's specialty?

The provider's specialty is General Practice with taxonomy code 208D00000X.

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About Gautam Ganguly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GAUTAM GANGULY (NPI 1669849824) is an individual general practice provider in Beverly Hills, Florida, licensed in Florida (ACN1448) and active in the NPI registry since August 2015. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1669849824

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameGAUTAM GANGULY

Location Address3775 N LECANTO HWYBeverly Hills, FL 34465-3559

Mailing AddressPo Box 640573, Ste 146Beverly Hills, FL 34464-0573 · (352) 746-0600 · Fax (352) 746-0607

Phone(352) 746-0600

Fax(352) 746-0607

Sole ProprietorYes

Medical School CMSOtherGraduated 1998

Enumeration DateAugust 24, 2015

Last NPPES UpdateSeptember 12, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 12, 2025

✔ NPI 1669849824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Licenses✔ Licensed in FL · ACN1448✔ Licensed in PR · 019167

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

3775 N LECANTO HWY, Beverly Hills, FL 34465

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Secondary Practice Locations 2

Location 13775 N Lecanto HwyBeverly Hills, FL 34465-3559 · Phone (352) 746-0600

Location 21542 Kingsley Ave Ste 146Orange Park, FL 32073-4547 · Phone (904) 269-2990

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gautam Ganguly is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688950066

PECOS Enrollment IDI20170419002304, I20220721001788

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

85 services35 patients

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WEST FLORIDA MEDICAL ASSOCIATES P A

Internal Medicine