Peter Samo Dovgan, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

ME79594 Issued in FL

Practice address

655 S Apollo Blvd
Melbourne, FL 32901-1485

Phone

(321) 751-2707

Fax

(321) 255-2361

NPI assigned

Aug 31, 2006

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 2

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

Vascular Surgery

Education

Other, 1991

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)

Hospital & facility affiliations

• Concierge Home Care Home health agency, Melbourne, FL, CCN 687040
• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
• Orlando Health Melbourne Hospital Hospital, Melbourne, FL, CCN 100291
• Viera Hospital Hospital, Melbourne, FL, CCN 100315

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pdovgan71561@epicdirect.hf.org
• Direct secure messaging: peterdovgan@mab.medentdirect.com

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.

• Medical Associates of Brevard LLC

  • Multi-Specialty Clinic/Center
  • Melbourne, FL
  • NPI 1861400103
  Medicare reassignment Care Compare group NPD
• Space Coast Vascular Inc

  • Specialist
  • Melbourne, FL
  • NPI 1598938250
  Authorized official Same address or phone

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

• Ajl Nursing Services, LLC

  dba Concierge Home Care

  • Home Health Agency
  • Melbourne, FL
  • NPI 1184183022
  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  dba First Flight

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728
  Care Compare affiliation
• Ohmh, LLC

  dba Orlando Health Melbourne Hospital

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1033937883
  Care Compare affiliation
• Viera Hospital Inc

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1730494816
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1396857611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S APOLLO BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011485",
            "telephone_number": "321-751-2707",
            "fax_number": "321-255-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S APOLLO BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011485",
            "telephone_number": "321-751-2707",
            "fax_number": "321-255-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVGAN",
        "first_name": "PETER",
        "middle_name": "SAMO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME79594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256748200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas D Weber DC PA (weber chiropractic)
• Douglas Ward, P.a.
• Jeannelle Douglas
• Daniel Vincent Dourney, PT
• Jorge Arnold Dovale Ricardo, DMD
• Brian Christopher Dowdell, MD
• Clark Andrew Downey, D.D.S
• Tara Downs
• Nicole C Doyle, APRN
• Dr Joseph D Paolucci MD PA LLC

• Vascular Surgery Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Vascular Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.