Individual provider Active NPI

Manjunath Gopal Raju

  • Interventional Cardiology Physician
  • Winter Park, FL
National Provider Identifier
1528251618
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME172591 Issued in FL
Practice address
1605 W Fairbanks Ave
Winter Park, FL 32789-4603
Phone
(407) 845-8356
NPI assigned
Aug 22, 2007
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X ME172591 FL Primary
Interventional Cardiology Physician 207RI0011X MD181855 OR

Addresses

Primary practice location

1605 W Fairbanks Ave
Winter Park, FL 32789-4603

Mailing address

1605 W Fairbanks Ave
Winter Park, FL 32789-4603
Phone (407) 845-8356

Other identifiers 1

IdentifierTypeStateIssuer
127914600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170517001980 OR Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 3375683170 Reassigns benefits to 1 organization
I20250815001300 FL Practitioner - Internal Medicine 3375683170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

1613 N Mills Ave
Orlando, FL 32803-1849
Phone (407) 894-4474

2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050

2100 Ocoee Apopka Rd
Apopka, FL 32703-9210

25 S Terry Ave
Suite 320
Orlando, FL 32805-1843
Phone (844) 407-4070

2501 N Orange Ave
Orlando, FL 32804-4641

258 S Chickasaw TRL
Orlando, FL 32825-3501

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

2984 Alafaya TRL
Suite 1000
Oviedo, FL 32765-7628
Phone (407) 894-4474

400 Celebration PL
Celebration, FL 34747-4970

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

631 E Altamonte Dr
Suite 231
Altamonte Springs, FL 32701-4802
Phone (407) 303-5214

689 E Altamonte Dr
Altamonte Springs, FL 32701-4801
Phone (407) 894-4474

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting38
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Hospital District CurrentSince Mar 1, 2020 Accepting new patients
Bay Area Hospital District CurrentSince Mar 1, 2020 Accepting new patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Jul 14, 2025 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jul 14, 2025 Accepting new patients
Peacehealth Past Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mgopalraju345787@direct.peacehealth.org
  • Direct secure messaging: mraju367677@direct.hfhs.org
  • Direct secure messaging: mraju4669073@adventhealth.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1528251618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 W FAIRBANKS AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894603",
            "telephone_number": "407-845-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 W FAIRBANKS AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894603",
            "telephone_number": "407-845-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "MANJUNATH",
        "middle_name": "GOPAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME172591",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD181855",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127914600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.