Individual provider Active NPI

Osvaldo Emmanuel Duran Melendez

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1114481892
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME166747 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-1134
Phone
(352) 265-5911
Fax
(352) 265-5606
NPI assigned
Jan 26, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 36428 PR
Emergency Medicine Physician 207P00000X ME166747 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-1134

Mailing address

PO Box 100186
Gainesville, FL 32610-0207
Phone (352) 265-5911

Other practice location 1

1515 SW Archer Rd
Gainesville, FL 32608-1134
Phone (352) 273-7500

Other identifiers 1

IdentifierTypeStateIssuer
123047600MedicaidFL

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
I20240821000039 FL Practitioner - Emergency Medicine 6709324809 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME166747FLMDEmergency Medicine Physician
36428PRMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 3, 2024 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 3, 2024 Accepting new patients

Locations

1515 SW Archer Rd
Gainesville, FL 32608
Phone (352) 265-0916

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: oduranmelendez711429@direct.shands.ufl.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1548460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1114481892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100186",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100207",
            "telephone_number": "352-265-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326101134",
            "telephone_number": "352-265-5911",
            "fax_number": "352-265-5606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326081134",
            "country_code": "US",
            "telephone_number": "352-273-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURAN MELENDEZ",
        "first_name": "OSVALDO",
        "middle_name": "EMMANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-26",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "36428",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME166747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123047600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.