NPIMap

Individual provider Active NPI

Prerna Vijayvargiya, MD

  • Family Medicine Physician
  • Merritt Island, FL
National Provider Identifier
1043210826
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME68903 Issued in FL
Practice address
220 N Sykes Creek Pkwy Ste 301
Merritt Island, FL 32953-3490
Phone
(321) 361-5536
Fax
(321) 361-5543
NPI assigned
Jul 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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 ME68903 FL Primary

Addresses

Primary practice location

220 N Sykes Creek Pkwy Ste 301
Merritt Island, FL 32953-3490

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306

Other identifiers 1

IdentifierTypeStateIssuer
378881400MedicaidFL

Other names 1

  • Dr. Prerna Agrawal Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100602000551 FL Practitioner - Family Practice 7214066174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Practice addresses (Care Compare)

699 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3562

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME68903FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC Family Medicine CurrentSince Mar 31, 2014 Accepting new patients
Health First Medical Group, LLC CurrentSince Mar 31, 2014 Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 404
Cocoa Beach, FL 32931
Phone (321) 868-2778

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

220 N Sykes Creek Pkwy
Ste 301
Merritt Island, FL 32953
Phone (321) 361-5535

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

Interoperability endpoints

  • Direct secure messaging: pvijayvargiya22981@epicdirect.hf.org

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.

Hospital & facility affiliations 7

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1043210826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N SYKES CREEK PKWY STE 301",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533490",
            "telephone_number": "321-361-5536",
            "fax_number": "321-361-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIJAYVARGIYA",
        "first_name": "PRERNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME68903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378881400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRERNA",
            "last_name": "AGRAWAL",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.