Individual provider Active NPI

Dwarka G Nath, M D

  • Gastroenterology Physician
  • Davenport, FL
National Provider Identifier
1003966870
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
51613 Issued in FL
Practice address
40124 Highway 27 Ste 204
Davenport, FL 33837-5905
Phone
(863) 419-2156
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 51613 FL Primary

Addresses

Primary practice location

40124 Highway 27 Ste 204
Davenport, FL 33837-5905

Mailing address

40124 Highway 27 Ste 204
Davenport, FL 33837-5905
Phone (863) 419-2156

Other practice location 1

825 Century Medical Dr
Titusville, FL 32796-2113
Phone (321) 268-6224

Other identifiers 1

IdentifierTypeStateIssuer
052599500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120329000472 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 3375703291 Reassigns benefits to 3 organizations
I20200825000556 VI Practitioner - Gastroenterology 3375703291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

40124 Hwy 27
Suite 204
Davenport, FL 33837-5905
Phone (863) 419-2156

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy37
Upper gastrointestinal (GI) endoscopy for acid reflux81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51613FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Jul 23, 2020 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Jul 23, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Apr 11, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Apr 11, 2022 Accepting new patients
Omni Healthcare, Inc. Gastroenterology CurrentSince Dec 1, 2020 Accepting new patients
Florida Hospital Physician Group Inc Gastroenterology CurrentSince Jul 28, 2022 Accepting new patients

Locations

40124 Highway 27
Ste 204
Davenport, FL 33837
Phone (863) 419-2156

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

425 S 11th St
Ste 1
Lake Wales, FL 33853
Phone (844) 634-3627

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1344 S Apollo Blvd
Ste 406
Melbourne, FL 32901
Phone (321) 253-4032

95 Bulldog Blvd
Ste 202
Melbourne, FL 32901
Phone (321) 676-1870

5005 Port St John Pkwy
Ste 2300
Port St John, FL 32927
Phone (321) 633-8663

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

845 Century Medical Dr
Titusville, FL 32796
Phone (321) 268-6831

250 Harrison St
Titusville, FL 32780
Phone (321) 268-6868

825 Century Medical Dr
Titusville, FL 32796
Phone (321) 567-4991

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dnath279188@adventhealth.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1003966870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40124 HIGHWAY 27 STE 204",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375905",
            "telephone_number": "863-419-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40124 HIGHWAY 27 STE 204",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375905",
            "telephone_number": "863-419-2156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Century Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "327962113",
            "country_code": "US",
            "telephone_number": "321-268-6224",
            "fax_number": "321-268-6229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATH",
        "first_name": "DWARKA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "51613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052599500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.