Individual provider Active NPI

Guido F Nodal Jr., M.D.

  • Psychiatry Physician
  • Palm Bay, FL
National Provider Identifier
1427064435
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME0050170 Issued in FL
Practice address
1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone
(305) 296-6668
Fax
(305) 296-6797
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X ME0050170 FL
Psychiatry Physician 2084P0800X ME0050170 FL Primary

Addresses

Primary practice location

1425 Malabar Rd NE
Palm Bay, FL 32907-2506

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-8078

Other practice location 1

3661 S Babcock St Ste 115
Melbourne, FL 32901-8205
Phone (321) 434-7604

Other identifiers 1

IdentifierTypeStateIssuer
046426100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address guido.nodal.1@4692.direct.athenahealth.com

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
I20040402000684 FL Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 7911999404 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6600 Cow Pen Rd
Suite 250
Miami Lakes, FL 33014-7622
Phone (305) 764-0194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0050170FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waves in Silence Psychological Services, Inc. Current Accepting new patients
Hni Medical Services of Florida, LLC Psychiatry CurrentSince Nov 10, 2019 Accepting new patients
Asana Integrated Medical Group PC Psychiatry CurrentSince Jan 7, 2019 Accepting new patients
Waves in Silence Psychological Services, Inc. CurrentSince Apr 1, 2023 Accepting new patients
Baycare Behavioral Health Associates LLC Psychiatry CurrentSince Jan 29, 2016 Accepting new patients
Peak Health LLC CurrentSince Jun 26, 2023 Accepting new patients
Baycare Behavioral Health Associates LLC Psychiatry CurrentSince Jan 29, 2016 Accepting new patients
Indian River Health Services Inc Psychiatry CurrentSince Feb 1, 2014 Accepting new patients
Holmes Regional Medical Center, Inc. Past Accepting new patients
Compass Health, Inc Past Accepting new patients
Hialeah Community Mental Health Center Inc PastSince Aug 18, 2006 Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

6600 Cow Pen Rd
Ste 250
Miami Lakes, FL 33014
Phone (305) 764-0194

15495 Eagle Nest Ln
Ste 215
Miami Lakes, FL 33014
Phone (305) 764-0194

215 Westward Dr
Miami Springs, FL 33166
Phone (305) 885-1792

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

7500 Rialto Blvd
Ste 1-140
Austin, TX 78735

Networks

  • Freedom Health HMO Network

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1427064435",
    "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": "321-434-8078",
            "fax_number": "321-434-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 MALABAR RD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072506",
            "telephone_number": "305-296-6668",
            "fax_number": "305-296-6797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3661 S Babcock St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329018205",
            "country_code": "US",
            "telephone_number": "321-434-7604",
            "fax_number": "321-725-1998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NODAL",
        "first_name": "GUIDO",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "FL",
            "license": "ME0050170",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0050170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046426100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "guido.nodal.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1200 Kennedy Dr Ste 1030",
            "city": "Key West",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330404023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.