NPIMap

Individual provider Active NPI

Nirav K. Thakkar, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Melbourne, FL
National Provider Identifier
1144579327
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME150365 Issued in FL
Practice address
2200 W Eau Gallie Blvd Ste 200
Melbourne, FL 32935-3166
Phone
(321) 253-2900
Fax
(321) 435-0100
NPI assigned
Sep 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 0101252586 VA
Hospitalist Physician 208M00000X 0101252586 VA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME150365 FL Primary

Addresses

Primary practice location

2200 W Eau Gallie Blvd Ste 200
Melbourne, FL 32935-3166

Mailing address

PO Box 361095
Melbourne, FL 32936-1095
Phone (321) 253-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130913000263 VA Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Geriatric Medicine 4981848926 Reassigns benefits to 1 organization
I20210629003770 FL Practitioner - Geriatric MedicinePractitioner - Internal Medicine 4981848926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Brevard LLCGroup PAC ID 4486558012, 75 clinicians

Practice addresses (Care Compare)

2200 W Eau Gallie Blvd
Suite 200
Melbourne, FL 32935-3166
Phone (321) 255-1500

Hospital & facility affiliations

  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
  • Palm Bay Hospital Hospital, Palm Bay, FL, CCN 100316
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Uva Community Health Medical Group, LLC CurrentSince Jan 12, 2016 Accepting new patients
Medical Associates of Brevard LLC CurrentSince Aug 1, 2021 Accepting new patients
Uva Community Health Medical Group, LLC CurrentSince Jan 12, 2016 Accepting new patients

Locations

1305 Hickory St
Melbourne, FL 32901
Phone (321) 255-1500

2200 W Eau Gallie Blvd
Ste 200
Melbourne, FL 32935
Phone (321) 255-1500

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

812 W Stuart Dr
Galax, VA 24333
Phone (276) 238-3318

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

Interoperability endpoints

  • Direct secure messaging: niravthakkar@mab.medentdirect.com
  • Direct secure messaging: nthakkar71451@epicdirect.hf.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1144579327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361095",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329361095",
            "telephone_number": "321-253-2900",
            "fax_number": "321-435-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W EAU GALLIE BLVD STE 200",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353166",
            "telephone_number": "321-253-2900",
            "fax_number": "321-435-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "NIRAV",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0101252586",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101252586",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME150365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.