Prody Urology, PLLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

PRODY UROLOGY, PLLC

Practice address

575 S Wickham Rd Ste B
West Melbourne, FL 32904-1170

Phone

(321) 308-5060

NPI assigned

Feb 7, 2019

Organization subpart

No

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

Authorized official

Name

Prodromos BorborogluNPI 1770543894

Title

Physician

Phone

(321) 308-5060

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DCGHBD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Prodromos Gordon Borboroglu, M.D.

  • Urology Physician
  • West Melbourne, FL
  • NPI 1770543894
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549497600000",
    "number": "1578028197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 S WICKHAM RD STE B",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041170",
            "telephone_number": "321-308-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 S WICKHAM RD STE B",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041170",
            "telephone_number": "321-308-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODY UROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-02-07",
        "status": "A",
        "authorized_official_last_name": "BORBOROGLU",
        "authorized_official_first_name": "PRODROMOS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "321-308-5060"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in West Melbourne, FL
• Providers in West Melbourne, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.