Gustavo A Prada, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME120490 Issued in FL

Practice address

1505 53Rd Ave E
Bradenton, FL 34203-4249

Phone

(941) 357-7950

Fax

(941) 840-1003

NPI assigned

Apr 6, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dedicated Senior Medical Center of Florida, LLC 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles (5 of 7)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366

  FL

  Medicare reassignment Care Compare group NPD
• David a Butler DO LLC

  • Family Medicine Physician
  • Port Charlotte, FL
  • NPI 1669759080

  Family Medicine

  NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Jacksonville, FL
  • NPI 1033626122
  NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1326337759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 53RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034249",
            "telephone_number": "941-357-7950",
            "fax_number": "941-840-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 53RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034249",
            "telephone_number": "941-357-7950",
            "fax_number": "941-840-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADA",
        "first_name": "GUSTAVO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME120490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013637500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Powell Supportive Services Inc
• Kathleen Murphy Powers, RN IBCLC
• Sima Powers, APN
• Practice of Dr. Edwin Chung
• Practitioners at Home Direct LLC
• Coleman Sims Pratt II, MD
• Anne Prault, COTA
• Precise Home Companions
• Precise Home Companions
• Precise Ultrasound Inc

• All providers in Bradenton, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.