American Medical Group – Infectious Disease Physician, NPI 1720017882
Infectious Disease Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for American Medical Group
417 Racetrack Rd NW
Fort Walton Beach, FL 325474612
Phone: (850) 862-3979
Fax: (850) 862-0605
Type: Location
1025 Beal Pkwy N Ste C
Fort Walton Beach, FL 325471481
Phone: (850) 374-3806
Fax: (850) 862-0605
Type: Location
1025 Beal Pkwy N Ste A
Fort Walton Beach, FL 325471481
Phone: (850) 374-8220
Fax: (850) 862-0605
Type: Location
351 N Ferdon Blvd
Crestview, FL 325362727
Phone: (850) 862-3979
Fax: (850) 862-0605
Type: Location
1710 Lisenby Ave
Panama City, FL 324053730
Phone: (850) 807-4420
Fax: (850) 862-0605
Type: Location
1326 Lewis Turner Blvd
Fort Walton Beach, FL 325471139
Phone: (850) 855-4048
Fax: (850) 855-4068
Type: Location
1921 E Nine Mile Rd
Pensacola, FL 325147747
Phone: (850) 999-5837
Fax: (850) 862-0605
Type: Location
137 Crystal Beach Dr Ste 121
Destin, FL 325413573
Phone: (850) 807-4388
Fax: (850) 862-0605
Type: Location
917, Mar Walt Drive, Wright, Fort Walton Beach, Okaloosa County, Florida, 32547, United States
FORT WALTON BEACH, FL 325476651
Phone: (850) 862-3979
Fax: (850) 862-0605
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-07-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-07-31 (1043 days ago).
Enrollment records
2
Earliest due date
2023-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20050422000315 | O | Clinic/Group Practice | FL | 2025-09-30 |
| O20170724001257 | O | Physician - Infectious Disease | FL | 2023-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32547)
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