Graciela O Deboccardo, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

134410 Issued in NY

Practice address

2852 Tamiami TRL Ste 1
Port Charlotte, FL 33952-5100

Phone

(941) 505-8720

Fax

(941) 505-8747

NPI assigned

Jul 14, 2006

Last updated

Jan 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY, 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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charlotte Nephrology Associates PAGroup PAC ID 8325183569, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Fawcett Hospital Hospital, Port Charlotte, FL, CCN 100236
• Adventhealth Port Charlotte Hospital, Port Charlotte, FL, CCN 100077

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: graciela.de.boccardo.1@15644.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4

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.

• Charlotte Nephrology Associates PA

  • Nephrology Physician
  • Port Charlotte, FL
  • NPI 1144273541
  Medicare reassignment Care Compare group
• Florida Kidney Physicians, LLC

  • Nephrology Physician
  • Temple Terrace, FL
  • NPI 1760831564
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Transplant Department of Mount Sinai

  • Transplant Surgery Physician
  • New York, NY
  • NPI 1588937064
  Medicare reassignment NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Nephrology

  Medicare reassignment NPD
• Florida Kidney Physicians , LLC

  • Nephrology Physician
  • Melbourne, FL
  • NPI 1205506722
  NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Montefiore Medical Center

  dba Montefiore Community Pharmacy @ CHAM

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD

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

• Adventhealth Port Charlotte Inc

  dba Adventhealth Port Charlotte

  • General Acute Care Hospital
  • Port Charlotte, FL
  • NPI 1760299093
  Care Compare affiliation
• Fawcett Memorial Hospital, Inc.

  dba HCA Florida Fawcett Hospital

  • General Acute Care Hospital
  • Port Charlotte, FL
  • NPI 1417901406
  Care Compare affiliation

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1609892553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 TAMIAMI TRL STE 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525100",
            "telephone_number": "941-505-8720",
            "fax_number": "941-505-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 TAMIAMI TRL STE 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525100",
            "telephone_number": "941-505-8720",
            "fax_number": "941-505-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOCCARDO",
        "first_name": "GRACIELA",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "134410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01126618",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0591181",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luis Manuel De la Puente, DDS
• Teresita C De Lara, M.D.
• Rita Felicia De Palma, ARNP
• Chitradeep De, MD
• Christina A Dea
• Pamela Debus, ARNP
• Nicholas Decastro, B.A.
• Deep Creek Physical Therapy Inc
• Deep Creek RNC, LLC (Port Charlotte Rehabilitation Center)
• Defilippis Chiropractic Inc.

• Nephrology Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.