Individual provider Active NPI

Eugene H Go, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Port St John, FL
National Provider Identifier
1528052065
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME 97535 Issued in FL
Practice address
5005 Port St John Pkwy
Suite 2600
Port St John, FL 32927-4305
Phone
(321) 504-7375
Fax
(321) 504-0737
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME 97535 FL Primary

Addresses

Primary practice location

5005 Port St John Pkwy
Suite 2600
Port St John, FL 32927-4305

Mailing address

805 Century Medical Dr
Suite C
Titusville, FL 32796-2100
Phone (321) 268-6264

Other identifiers 1

IdentifierTypeStateIssuer
278187500MedicaidFL

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
I20080604000700 FL Practitioner - Endocrinology 7618047440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Brevard Medical Support Inc 62 clinicians

Practice addresses (Care Compare)

5005 Port St John Pkwy
Suite 2600
Port St John, FL 32927-4305
Phone (321) 268-6834

Hospital & facility affiliations

  • Parrish Medical Center Hospital, Titusville, FL, CCN 100028
  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
75.26
Promoting interoperability
100
Improvement activities
40
Cost
78.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 97535FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Brevard Medical Support, Inc CurrentSince Jul 1, 2007 Accepting new patients
North Brevard Medical Support, Inc Endocrinology, Diabetes & Metabolism CurrentSince Aug 8, 2021 Accepting new patients

Locations

5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556

5005 Port St John Pkwy
#2600
Port St John, FL 32927

5005 Port St John Pkwy
Ste 2600
Port St John, FL 32927
Phone (321) 268-6834

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

805 Century Medical Dr
Ste C
Titusville, FL 32796
Phone (321) 268-6264

Interoperability endpoints

  • Direct secure messaging: eugene.go.1@17832.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1528052065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 CENTURY MEDICAL DR",
            "address_2": "SUITE C",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962100",
            "telephone_number": "321-268-6264",
            "fax_number": "321-504-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 PORT ST JOHN PKWY",
            "address_2": "SUITE 2600",
            "city": "PORT ST JOHN",
            "state": "FL",
            "postal_code": "329274305",
            "telephone_number": "321-504-7375",
            "fax_number": "321-504-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GO",
        "first_name": "EUGENE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME 97535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278187500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St John, FL

Sources for this page

Verify at the official NPI Registry.