Organization Active NPI

Milestones Pediatrics LLC

Doing business as Milestones Pediatrics

  • Pediatrics Physician
  • Gainesville, FL
National Provider Identifier
1508343641
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME116979 Issued in FL
Legal business name
MILESTONES PEDIATRICS LLC
Doing business as
Milestones Pediatrics
Practice address
100 SW 75TH St Ste 101
Gainesville, FL 32607-5775
Phone
(352) 559-8911
Fax
(352) 559-8877
NPI assigned
Jul 21, 2018
Last updated
Aug 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Authorized official

Name
Priyanka VyasNPI 1306050232
Title
Owner
Phone
(501) 231-4079

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
Pediatrics Physician 208000000X ME116979 FL Primary

Addresses

Primary practice location

100 SW 75TH St Ste 101
Gainesville, FL 32607-5775

Mailing address

6910 NW 52ND LN
Gainesville, FL 32653-3954
Phone (352) 559-8911

Other identifiers 1

IdentifierTypeStateIssuer
100919100MedicaidFL

Other names 1

  • Milestones Pediatrics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181004002285 FL Part B Supplier - Clinic/Group Practice 4082966957 Receives reassigned benefits from 1 practitioner
Practice locations: Gainesville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2154089Milestones Pediatrics100 SW 75TH Street, Gainesville, FL 32607Certificate of waiverSep 5, 2026

National Provider Directory

National Provider Directory

Locations

100 SW 75th St
Ste 101
Gainesville, FL 32607
Phone (352) 331-5277

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1532131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598486400000",
    "number": "1508343641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 NW 52ND LN",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326533954",
            "telephone_number": "352-559-8911",
            "fax_number": "352-559-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SW 75TH ST STE 101",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326075775",
            "telephone_number": "352-559-8911",
            "fax_number": "352-559-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONES PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-21",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "VYAS",
        "authorized_official_first_name": "PRIYANKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-231-4079"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME116979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100919100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Milestones Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.