Individual provider Active NPI

Preeti Bimbrahw, MD

  • Pediatrics Physician
  • Melbourne, FL
National Provider Identifier
1346456647
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME112749 Issued in FL
Practice address
8095 Spyglass Hill Rd
Suite 104
Melbourne, FL 32940-8290
Phone
(321) 241-6400
Fax
(321) 428-3945
NPI assigned
May 15, 2007
Last updated
Jun 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME112749 FL Primary

Addresses

Primary practice location

8095 Spyglass Hill Rd
Suite 104
Melbourne, FL 32940-8290

Mailing address

8095 Spyglass Hill Rd
Suite 104
Melbourne, FL 32940-8290
Phone (321) 241-6400

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
I20160523001963 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7214083823

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Medical Associates of Brevard LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: preetibimbrahw@mab.medentdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1346456647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8095 SPYGLASS HILL RD",
            "address_2": "SUITE 104",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408290",
            "telephone_number": "321-241-6400",
            "fax_number": "321-428-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8095 SPYGLASS HILL RD",
            "address_2": "SUITE 104",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408290",
            "telephone_number": "321-241-6400",
            "fax_number": "321-428-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIMBRAHW",
        "first_name": "PREETI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME112749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.