Mr Ilyas Gutale, PA-C is a medicare enrolled "Emergency Medicine" in Leesburg, Florida. His current practice location is
600 E Dixie Ave, Leesburg, Florida. You can reach out to his office (for appointments etc.) via phone at
(352) 323-5762.
Mr Ilyas Gutale is licensed to practice in Nevada (license number PA1776) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497993802.
Provider's Profile
| Full Name | Mr Ilyas Gutale |
|---|
| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 600 E Dixie Ave, Leesburg, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1497993802
- Provider Enumeration Date: 01/23/2009
- Last Update Date: 06/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 1557416021
- Enrollment ID: I20090904000298
Medical Identifiers
Medical identifiers for Mr Ilyas Gutale such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1497993802 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | MA053832 (Pennsylvania) | Secondary |
| 363A00000X | Physician Assistant | 54636 (California) | Secondary |
| 363A00000X | Physician Assistant | PA1776 (Nevada) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA 9105989 (Florida) | Secondary |
| 207P00000X | Emergency Medicine | PA1776 (Nevada) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Ilyas Gutale is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Ilyas Gutale, PA-C
600 E Dixie Ave,
Leesburg, FL 34748-5925
Ph: (352) 323-5762 | Mr Ilyas Gutale, PA-C
600 E Dixie Ave,
Leesburg, FL 34748-5925
Ph: (352) 323-5762 |
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