Individual provider Active NPI

Gerald Molloy, M.D.

  • Neurological Surgery Physician
  • Melbourne, FL
National Provider Identifier
1093862278
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME106745 Issued in FL
Practice address
709 S Harbor City Blvd Ste 110
Melbourne, FL 32901-1906
Phone
(321) 499-4646
Fax
(321) 270-9449
NPI assigned
Jan 3, 2007
Last updated
May 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME106745 FL Primary

Addresses

Primary practice location

709 S Harbor City Blvd Ste 110
Melbourne, FL 32901-1906

Mailing address

709 S Harbor City Blvd Ste 110
Melbourne, FL 32901-1906
Phone (321) 499-4646

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
I20250211000035 FL Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 0749382018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME106745FLMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Spine & Wellness CurrentSince May 12, 2024 Accepting new patients
Physician Billing SFN Neurological Surgery PastSince Nov 1, 2005 Accepting new patients
Broward Neurosurgeons LLC Neurological Surgery PastSince Jul 1, 2018 Accepting new patients

Locations

709 S Harbor City Blvd
Ste 110
Melbourne, FL 32901
Phone (321) 499-4646

Interoperability endpoints

  • Direct secure messaging: gerald.molloy@hca4.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FDJDDD/Endpoint/FDJDDD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1093862278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 S HARBOR CITY BLVD STE 110",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011906",
            "telephone_number": "321-499-4646",
            "fax_number": "321-270-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 S HARBOR CITY BLVD STE 110",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011906",
            "telephone_number": "321-499-4646",
            "fax_number": "321-270-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLOY",
        "first_name": "GERALD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME106745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.