Individual provider Active NPI

George Elkomos, M.D.

  • Family Medicine Physician
  • Viera, FL
National Provider Identifier
1043644966
Registry record updated Apr 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME123497 Issued in FL
Practice address
2900 Veterans Way
Viera, FL 32940-8007
Phone
(321) 637-3788
NPI assigned
Aug 27, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2017

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 ME123497 FL Primary

Addresses

Primary practice location

2900 Veterans Way
Viera, FL 32940-8007

Mailing address

2900 Veterans Way
Viera, FL 32940-8007
Phone (321) 637-3788

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
I20160827000074 FL Order and Referring Only - Family PracticePractitioner - Family Practice 8729373931

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME123497FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491004800000",
    "number": "1043644966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "321-637-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "321-637-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKOMOS",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-27",
        "last_updated": "2017-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME123497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Viera, FL

Sources for this page

Verify at the official NPI Registry.