Individual provider Active NPI

Gopal Gadodia, M.D.

  • Interventional Cardiology Physician
  • Melbourne, FL
National Provider Identifier
1306842984
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME57616 Issued in FL
Practice address
2200 W Eau Gallie Blvd
Ste 200
Melbourne, FL 32935-3166
Phone
(321) 255-1500
Fax
(321) 254-0400
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME57616 FL
Interventional Cardiology Physician 207RI0011X ME57616 FL Primary

Addresses

Primary practice location

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

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
051642200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20031125000077 FL Practitioner - Cardiovascular Disease (Cardiology) 1759285380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1978
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

PO Box
Suite 361095
Melbourne, FL 32936

PO Box
Suite 361095
Melbourne, FL 32936-1095

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting45
Pacemaker insertion or repair20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME57616FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Brevard LLC CurrentSince Nov 15, 2004 Accepting new patients

Locations

655 S Apollo Blvd
Ste 1
Melbourne, FL 32901
Phone (321) 327-2440

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

2290 W Eau Gallie Blvd
Ste 108
Melbourne, FL 32935
Phone (321) 253-2700

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

Interoperability endpoints

  • Direct secure messaging: gopalgadodia@mab.medentdirect.com
  • Direct secure messaging: ggadodia71696@epicdirect.hf.org

Organizations & group practices 1

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 5

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1306842984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W EAU GALLIE BLVD",
            "address_2": "STE 200",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353166",
            "telephone_number": "321-255-1500",
            "fax_number": "321-254-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W EAU GALLIE BLVD",
            "address_2": "STE 200",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353166",
            "telephone_number": "321-255-1500",
            "fax_number": "321-254-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADODIA",
        "first_name": "GOPAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME57616",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME57616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051642200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.