Individual provider Active NPI

Gopen Narayan Mukherjee, MD

  • Nephrology Physician
  • Kissimmee, FL
National Provider Identifier
1457326431
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME38450 Issued in FL
Practice address
1101 N Central Ave
Kissimmee, FL 34741-4405
Phone
(407) 851-5600
Fax
(407) 438-9585
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME38450 FL Primary

Addresses

Primary practice location

1101 N Central Ave
Kissimmee, FL 34741-4405

Mailing address

3885 Oakwater Cir
Orlando, FL 32806-6257
Phone (407) 851-5600

Other identifiers 3

IdentifierTypeStateIssuer
696778OtherFLUNITED HEALTHCARE
49049OtherFLBC/BS
2385475OtherFLAETNA

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
I20050618000094 FL Practitioner - NephrologyPractitioner - Internal Medicine 3476597576 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME38450FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Central Florida, P.a. Nephrology CurrentSince Jun 1, 2010 Accepting new patients
Central Florida Kidney Specialists Inc Nephrology CurrentSince Jun 1, 2023 Accepting new patients

Locations

1121 N Central Ave
Kissimmee, FL 34741
Phone (407) 933-1221

1101 N Central Ave
Kissimmee, FL 34741
Phone (407) 284-1993

1511 Sligh Blvd
Unit A
Orlando, FL 32806
Phone (407) 317-9000

3885 Oakwater Cir
Orlando, FL 32806
Phone (407) 816-5700

2501 N Orange Ave
Ste 537N
Orlando, FL 32804
Phone (407) 894-4693

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1457326431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3885 OAKWATER CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066257",
            "telephone_number": "407-851-5600",
            "fax_number": "407-438-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N CENTRAL AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414405",
            "telephone_number": "407-851-5600",
            "fax_number": "407-438-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHERJEE",
        "first_name": "GOPEN",
        "middle_name": "NARAYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME38450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "696778",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "49049",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2385475",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.