Individual provider Active NPI

Mirza Ivelisse Gagot-Rivera, MD

  • Family Medicine Physician
  • Arcadia, FL
National Provider Identifier
1023079621
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ACN224 Issued in FL
Practice address
815 N Mills Ave Ste 103
Arcadia, FL 34266-8716
Phone
(863) 491-7580
Fax
(863) 491-7584
NPI assigned
Mar 31, 2006
Last updated
Jan 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ACN224 FL Primary

Addresses

Primary practice location

815 N Mills Ave Ste 103
Arcadia, FL 34266-8716

Mailing address

34 S Baldwin Ave
Arcadia, FL 34266-3387
Phone (863) 993-4601

Other identifiers 2

IdentifierTypeStateIssuer
277007500MedicaidFL
56592OtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • Mirza Gagot-Rivera Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070611000132 FL Practitioner - General Practice 1355302829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Department of HealthGroup PAC ID 3072424282, 126 clinicians

Practice addresses (Care Compare)

34 S Baldwin Ave
Arcadia, FL 34266-3387
Phone (863) 993-4601

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Sep 6, 2006 Accepting new patients
Florida Department of Health Past Accepting new patients

Locations

1031 E Oak St
Arcadia, FL 34266
Phone (863) 491-7580

34 S Baldwin Ave
Arcadia, FL 34266
Phone (863) 491-7580

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1023079621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 S BALDWIN AVE",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342663387",
            "telephone_number": "863-993-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N MILLS AVE STE 103",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668716",
            "telephone_number": "863-491-7580",
            "fax_number": "863-491-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGOT-RIVERA",
        "first_name": "MIRZA",
        "middle_name": "IVELISSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ACN224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277007500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "56592",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRZA",
            "last_name": "GAGOT-RIVERA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arcadia, FL

Sources for this page

Verify at the official NPI Registry.