NPIMap

Organization Active NPI

Gulf Coast Infectious Diseases Inc

  • Infectious Disease Physician
  • Pensacola, FL
National Provider Identifier
1437109733
Registry record updated Jul 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
GULF COAST INFECTIOUS DISEASES INC
Practice address
2120 E Johnson Ave
Pensacola, FL 32514
Phone
(850) 549-4755
Fax
(850) 549-4760
NPI assigned
May 10, 2006
Last updated
Jul 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2020

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

Authorized official

Name
Pardeep Kumari, MDNPI 1083697320
Title
President
Phone
(850) 549-4755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X Primary

Addresses

Primary practice location

2120 E Johnson Ave
Pensacola, FL 32514

Mailing address

PO Box 11640
Pensacola, FL 32524
Phone (850) 549-4755

Other identifiers 2

IdentifierTypeStateIssuer
529928850MedicaidAL
611374600OtherFLDEPT OF LABOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060922000046 FL Part B Supplier - Clinic/Group Practice 9537164769 Receives reassigned benefits from 17 practitioners
Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory

Locations

5151 N 9th Ave
#1405
Pensacola, FL 32504

8354 N Davis Hwy
Pensacola, FL 32514
Phone (850) 450-4865

8354 N Davis Hwy
Ste 100
Pensacola, FL 32514
Phone (850) 549-4755

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593907200000",
    "number": "1437109733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11640",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32524",
            "telephone_number": "850-549-4755",
            "fax_number": "850-549-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 E JOHNSON AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32514",
            "telephone_number": "850-549-4755",
            "fax_number": "850-549-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST INFECTIOUS DISEASES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-07-05",
        "certification_date": "2020-07-05",
        "status": "A",
        "authorized_official_last_name": "KUMARI",
        "authorized_official_first_name": "PARDEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-549-4755",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529928850",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "611374600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.