GARY EDWARD DECESARE MD NPI 1093941635

NPI Information

  • NPI: 1093941635
  • Provider Name: GARY EDWARD DECESARE, MD
  • Classification: Plastic Surgery - 208200000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 311 N CLYDE MORRIS BLVD STE 500
    DAYTONA BEACH, FL
    ZIP 32114
  • Phone: (386) 238-2244

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NPI Details

Gary Edward Decesare, MD is a plastic surgery in Daytona Beach, FL. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. Gary Edward Decesare, MD NPI is 1093941635. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

311 N CLYDE MORRIS BLVD STE 500
DAYTONA BEACH, FL
ZIP 32114-768
Phone: (386) 238-2244
Fax: (386) 239-2381

The NPI 1093941635 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/10/2009 and was last updated on 8/23/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2208200000XPlastic SurgeryME123142FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PENDINGMEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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