NPIMap

Organization Active NPI

Rupala Ghanshyam LLC

  • Nephrology Physician
  • Melbourne, FL
National Provider Identifier
1033956156
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
RUPALA GHANSHYAM LLC
Practice address
828 Venturi CT
Melbourne, FL 32940-1797
Phone
(321) 364-2080
NPI assigned
Jul 15, 2024
Last updated
Jul 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Stan Myers
Title
Credentialing Manager
Phone
(332) 330-3903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

828 Venturi CT
Melbourne, FL 32940-1797

Mailing address

828 Venturi CT
Melbourne, FL 32940-1797
Phone (321) 364-2080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240911004342 FL Part B Supplier - Clinic/Group Practice 4486194842 Receives reassigned benefits from 8 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1033956156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 VENTURI CT",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401797",
            "telephone_number": "321-364-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 VENTURI CT",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401797",
            "telephone_number": "321-364-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUPALA GHANSHYAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "STAN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "332-330-3903"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.