Individual provider Active NPI

Michael G Gindi

  • Student in an Organized Health Care Education/Training Program
  • Brooksville, FL
National Provider Identifier
1225667769
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone
(352) 592-2753
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036164566 IL
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

11375 Cortez Blvd
Brooksville, FL 34613-5409

Mailing address

1351 S Halsted St Unit 206
Chicago, IL 60607-5006

Other practice location 1

1505 Eastland Dr
Bloomington, IL 61701-3534
Phone (309) 661-2368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20260129003833 IL Practitioner - Internal Medicine 3173001245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1505 Eastland Dr
Bloomington, IL 61701-3534
Phone (309) 662-5506

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036164566ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jan 9, 2026 Accepting new patients

Locations

1505 Eastland Dr
Ste 320
Bloomington, IL 61701
Phone (309) 661-2368

1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Interoperability endpoints

  • Direct secure messaging: michael.gindi@hca4.eclinicaldirectplus.com

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1225667769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 S HALSTED ST UNIT 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606075006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11375 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135409",
            "telephone_number": "352-592-2753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 Eastland Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617013534",
            "country_code": "US",
            "telephone_number": "309-661-2368",
            "fax_number": "309-662-9709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GINDI",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036164566",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.