NPIMap

Individual provider Active NPI

Eduardo Rene Nevarez-Carrillo, M.D.

  • Family Medicine Physician
  • Melbourne, FL
National Provider Identifier
1386785624
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME97389 Issued in FL
Practice address
1223 Gateway Dr Ste 1a
Melbourne, FL 32901-2607
Phone
(321) 312-3459
Fax
(321) 409-1792
NPI assigned
Feb 9, 2007
Last updated
Apr 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME97389 FL Primary

Addresses

Primary practice location

1223 Gateway Dr Ste 1a
Melbourne, FL 32901-2607

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 312-3459

Other identifiers 2

IdentifierTypeStateIssuer
P01164156OtherFLRR MEDICARE
92683OtherFLBCBS

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
I20070614000305 FL Practitioner - Family Practice 7810095858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

1223 Gateway Dr
Melbourne, FL 32901-2607
Phone (321) 725-4500

4270 Minton Rd
Suite 120
West Melbourne, FL 32904-9579
Phone (321) 984-2933

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.79 of 100Reported as apm
Quality
86.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC CurrentSince Feb 15, 2013 Accepting new patients
Health First Medical Group, LLC Family Medicine CurrentSince Feb 15, 2013 Accepting new patients
First Care Family Physicians Past Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

1223 Gateway Dr
Melbourne, FL 32901
Phone (321) 549-0677

1223 Gateway Dr
Ste 1A
Melbourne, FL 32901
Phone (321) 434-6712

1223 Gateway Dr
Ste 1C
Melbourne, FL 32901
Phone (321) 728-6072

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

Interoperability endpoints

  • Direct secure messaging: enevarezcarrillo23536@epicdirect.hf.org

Organizations & group practices 3

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 9

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1386785624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-312-3459",
            "fax_number": "321-409-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 GATEWAY DR STE 1A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012607",
            "telephone_number": "321-312-3459",
            "fax_number": "321-409-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVAREZ-CARRILLO",
        "first_name": "EDUARDO",
        "middle_name": "RENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME97389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01164156",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "92683",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.