Stephen K Badolato, MD
Individual provider Active NPI Sports Medicine (Family Medicine) Physician · Melbourne, FL
NPI 1194728832 · NPPES record last updated Oct 22, 2007
Key facts
- NPI
- 1194728832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Family Medicine) Physician 207QS0010X
- License
- ME78710 (FL)
- Practice address
- 6300 N Wickham Rd
Ste 101 -108
Melbourne, FL 32940-2028 - Phone
- (321) 253-2169
- Fax
- (321) 253-1720
- NPI assigned
- May 26, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of South Florida College of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- H2 Rehabilitation Services of Florida LLC
D Badolato PA
Practice addresses (Care Compare)
3680 N Wickham Rd
Suite B
Melbourne, FL 32935-2327
Phone (321) 255-5500
6300 N Wickham Rd
Suite 101
Melbourne, FL 32940-2023
Phone (321) 253-2169
Hospital & facility affiliations
- Health First Home Care
- Concierge Home Care
- Viera Hospital
- Orlando Health Melbourne Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071112000588 | FL | Practitioner - Family Practice |
7810085610 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (1 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D Badolato PA | Sports Medicine | Current |
Accepting new patients |
Locations
6300 N Wickham Rd
Ste 101
Melbourne, FL 32940
Phone (321) 253-2169
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | ME78710 | FL | Yes |
Addresses
Primary practice location
6300 N Wickham Rd
Ste 101 -108
Melbourne, FL 32940-2028
Mailing address
247 Lansing Island Dr
Indian Harbour Beach, FL 32937-5102
Phone (321) 253-2169
NPI Registry JSON
{
"created_epoch": "1117065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193011200000",
"number": "1194728832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "247 LANSING ISLAND DR",
"city": "INDIAN HARBOUR BEACH",
"state": "FL",
"postal_code": "329375102",
"telephone_number": "321-253-2169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6300 N WICKHAM RD",
"address_2": "STE 101 -108",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329402028",
"telephone_number": "321-253-2169",
"fax_number": "321-253-1720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADOLATO",
"first_name": "STEPHEN",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-26",
"last_updated": "2007-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "FL",
"license": "ME78710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
- Patrick Anthony Baden
- Angelica Lisa Bader
- Dwayne K Badgett
- Craig J Badolato
- David W Badolato
- Mackenzie Baehr
- Priscilla Baer Schimkus
- Sheila Moss Baer
- Breanne Baez-Colantonio
- Stacey Marie Baggett
All providers in Melbourne, FL · Sports Medicine (Family Medicine) Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.