NPIMap

Individual provider Active NPI

Radharani S. Gollamudi, M.D.

  • Internal Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1245287713
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01072789A Issued in IN
Practice address
1630 Mason Ave Ste C
Daytona Beach, FL 32117-4503
Phone
(386) 238-9064
Fax
(386) 238-9064
NPI assigned
May 28, 2006
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01072789A IN Primary
Internal Medicine Physician 207R00000X ME109538 FL
Internal Medicine Physician 207R00000X 238672 NY

Addresses

Primary practice location

1630 Mason Ave Ste C
Daytona Beach, FL 32117-4503

Mailing address

1630 Mason Ave Ste C
Daytona Beach, FL 32117-4503
Phone (386) 238-9064

Other identifiers 2

IdentifierTypeStateIssuer
FB967YOtherFLMEDICARE
201173130MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110701000152 FL Practitioner - Internal Medicine 0547271652 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excellence Health LLCGroup PAC ID 0840534160, 49 clinicians

Practice addresses (Care Compare)

1630 Mason Ave
Suite C
Daytona Beach, FL 32117-4503
Phone (386) 238-9064

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.99 of 100Reported as group
Quality
84.82
Promoting interoperability
100
Improvement activities
40
Cost
61.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME109538FLMDInternal Medicine Physician
238672NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Internal Medicine Current Accepting new patients
Excellence Health, LLC CurrentSince Jul 1, 2018 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Oct 3, 2016 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Oct 3, 2016 Accepting new patients
Excellence Health Medical Clinics LLC CurrentSince Dec 26, 2024 Accepting new patients
Weirsdale Family Health Center Inc Internal Medicine Past Accepting new patients

Locations

806 S Douglas Rd
Ste 820
Coral Gables, FL 33134
Phone (305) 200-1915

1630 Mason Ave
Ste C
Daytona Beach, FL 32117
Phone (386) 238-9064

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

2029 Professional Center Dr
Orange Park, FL 32073
Phone (904) 264-8621

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Parkside Health and Rehabilitation CenterDeland, FL, CCN 105145 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2022
Oct 15, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1245287713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MASON AVE STE C",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174503",
            "telephone_number": "386-238-9064",
            "fax_number": "386-238-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MASON AVE STE C",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174503",
            "telephone_number": "386-238-9064",
            "fax_number": "386-238-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLAMUDI",
        "first_name": "RADHARANI",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01072789A",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME109538",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "238672",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "FB967Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201173130",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.