Organization Active NPI

Gulati & Associates PA

  • Nephrology Physician
  • Davie, FL
National Provider Identifier
1073524161
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME 75667 Issued in FL
Legal business name
GULATI & ASSOCIATES PA
Practice address
3105 N University Dr
Suite 209
Davie, FL 33024-2234
Phone
(954) 438-6080
Fax
(954) 499-5599
NPI assigned
Aug 11, 2006
Last updated
Feb 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Dr. Manjit S Gulati, MDNPI 1164433256
Title
Owner/President
Phone
(954) 438-6080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X ME 75667 FL Primary

Addresses

Primary practice location

3105 N University Dr
Suite 209
Davie, FL 33024-2234

Mailing address

10726 Charleston Place
Cooper City, FL 33026
Phone (954) 438-6080

Other identifiers 1

IdentifierTypeStateIssuer
254728700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101217000213 FL Part B Supplier - Clinic/Group Practice 4587852504 Receives reassigned benefits from 2 practitioners
Practice locations: Davie, FL

National Provider Directory

National Provider Directory

Locations

2655 Hollywood Blvd
Hollywood, FL 33020
Phone (833) 394-0714

3105 N University Dr
Ste 209
Hollywood, FL 33024
Phone (954) 438-6080

12145 Pembroke Rd
Pembroke Pines, FL 33025
Phone (954) 435-2553

7769 Johnson St
Pembroke Pines, FL 33024
Phone (954) 962-9640

Practitioners & affiliated clinicians

Practitioners 2

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1073524161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10726 CHARLESTON PLACE",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "33026",
            "telephone_number": "954-438-6080",
            "fax_number": "954-499-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 N UNIVERSITY DR",
            "address_2": "SUITE 209",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "330242234",
            "telephone_number": "954-438-6080",
            "fax_number": "954-499-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULATI & ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "GULATI",
        "authorized_official_first_name": "MANJIT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "954-438-6080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME 75667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254728700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.