Active NPI
Premier Cardiology of Vero Beach
- Cardiovascular Disease Physician
- Vero Beach, FL
National Provider Identifier
1114701497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- PREMIER CARDIOLOGY OF VERO BEACH
- Practice address
- 787 37TH St Ste 250
Vero Beach, FL 32960-7305 - Phone
- (772) 494-0794
- Fax
- (772) 494-0745
- NPI assigned
- Aug 21, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Vikranth Gongidi, DO
- Title
- Ceo
- Phone
- (772) 494-0794
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
787 37TH St Ste 250
Vero Beach, FL 32960-7305
Mailing address
787 37TH St Ste 250
Vero Beach, FL 32960-7305
Phone (772) 494-0794
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://fhir4.healow.com/fhir/r4/DECCDD
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Vero Beach, FL
- NPI 1609098581
Internal Medicine
-
- Nurse Practitioner
- Vero Beach, FL
- NPI 1093376709
-
- Primary Care Nurse Practitioner
- Vero Beach, FL
- NPI 1821923608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692576000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698105600000",
"number": "1114701497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "787 37TH ST STE 250",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329607305",
"telephone_number": "772-494-0794",
"fax_number": "772-494-0745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "787 37TH ST STE 250",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329607305",
"telephone_number": "772-494-0794",
"fax_number": "772-494-0745"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIER CARDIOLOGY OF VERO BEACH",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-21",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A",
"authorized_official_last_name": "GONGIDI",
"authorized_official_first_name": "VIKRANTH",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "772-494-0794",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.