Individual provider Active NPI

Mihai Radu, MD

  • Pediatrics Physician
  • Merritt Island, FL
National Provider Identifier
1023079175
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0055626 Issued in FL
Practice address
255 Fortenberry Rd
A3
Merritt Island, FL 32952-3601
Phone
(321) 453-1717
Fax
(855) 816-8510
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME0055626 FL Primary

Addresses

Primary practice location

255 Fortenberry Rd
A3
Merritt Island, FL 32952-3601

Mailing address

255 Fortenberry Rd
A3
Merritt Island, FL 32952-3601
Phone (321) 453-1717

Other identifiers 1

IdentifierTypeStateIssuer
063184100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0055626FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pediatric Group PA Pediatrics PastSince Feb 24, 2022 Accepting new patients
Mihai S Radu M D P a PastSince Jan 1, 1990 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGFDAA

Organizations & group practices 2

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1023079175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 FORTENBERRY RD",
            "address_2": "A3",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523601",
            "telephone_number": "321-453-1717",
            "fax_number": "855-816-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 FORTENBERRY RD",
            "address_2": "A3",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523601",
            "telephone_number": "321-453-1717",
            "fax_number": "855-816-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADU",
        "first_name": "MIHAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0055626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063184100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.